E Baten1,2,3, F Van Der Aa4, C Orye4, R Cartuyvels5, I Arijs6, K van Renterghem5,4,6. 1. Jessa Hospital, Stadsomvaart, 3050, Hasselt, Belgium. Evert.baten@gmail.com. 2. UZ Leuven, Herestraat, 3000, Leuven, Belgium. Evert.baten@gmail.com. 3. , Leuven, Belgium. Evert.baten@gmail.com. 4. UZ Leuven, Herestraat, 3000, Leuven, Belgium. 5. Jessa Hospital, Stadsomvaart, 3050, Hasselt, Belgium. 6. U Hasselt, Martelarenlaan 45, 3050, Hasselt, Belgium.
Abstract
PURPOSE: Antibiotic prophylaxis is standard procedure in transurethral resection of the prostate (TURP). We evaluated the necessity of antibiotic (AB) prophylaxis in TURP due to increasing microbial antibiotic resistance. METHODS: This is a prospective cohort study of 506 patients. Only patients with a pre-operative catheter/pyuria received AB-prophylaxis. Urine analysis (pre-operative, at discharge, and 3 week post-operative) was performed next to an analysis of the blood culture/irrigation fluid and of the resected prostatic tissue. Statistical analysis was performed using Fisher's exact test. RESULTS: 67/506 (13.2%) patients received prophylactic antibiotics. 56/67 (83.5%) patients had a pre-operative catheter and 11/67 (16.4%) had pre-operative pyuria in which a fluoroquinolone-resistance (FQ-R) rate of 69.2% in Escherichia coli (EC) was observed. Clinical infectious symptoms were present in 13/439 (2.9%) patients without antibiotic prophylaxis; 12/439 (2.7%) patients had uncomplicated fever (<38.5°) during or after hospitalization and only 1/439 patient (0.2%) was high degree fever (> 38.5°) observed. Uncomplicated fever developed in 7/67 (10.4%) patients who did receive AB-prophylaxis. FQ-R was observed in 60% of the positive urine cultures at discharge and in 53.8% 3 week post-operatively. CONCLUSIONS: Our data show a low infectious complication rate (2.9%) in patients without a pre-operative catheter or pyuria,undergoing TURP without AB-prophylaxis. These findings might question the current use of AB prophylaxis in TURP in patients without a pre-operative catheter or pyuria, in times of antibiotic stewardship due to the high rate of microbial-resistance in our population.
PURPOSE: Antibiotic prophylaxis is standard procedure in transurethral resection of the prostate (TURP). We evaluated the necessity of antibiotic (AB) prophylaxis in TURP due to increasing microbial antibiotic resistance. METHODS: This is a prospective cohort study of 506 patients. Only patients with a pre-operative catheter/pyuria received AB-prophylaxis. Urine analysis (pre-operative, at discharge, and 3 week post-operative) was performed next to an analysis of the blood culture/irrigation fluid and of the resected prostatic tissue. Statistical analysis was performed using Fisher's exact test. RESULTS: 67/506 (13.2%) patients received prophylactic antibiotics. 56/67 (83.5%) patients had a pre-operative catheter and 11/67 (16.4%) had pre-operative pyuria in which a fluoroquinolone-resistance (FQ-R) rate of 69.2% in Escherichia coli (EC) was observed. Clinical infectious symptoms were present in 13/439 (2.9%) patients without antibiotic prophylaxis; 12/439 (2.7%) patients had uncomplicated fever (<38.5°) during or after hospitalization and only 1/439 patient (0.2%) was high degree fever (> 38.5°) observed. Uncomplicated fever developed in 7/67 (10.4%) patients who did receive AB-prophylaxis. FQ-R was observed in 60% of the positive urine cultures at discharge and in 53.8% 3 week post-operatively. CONCLUSIONS: Our data show a low infectious complication rate (2.9%) in patients without a pre-operative catheter or pyuria,undergoing TURP without AB-prophylaxis. These findings might question the current use of AB prophylaxis in TURP in patients without a pre-operative catheter or pyuria, in times of antibiotic stewardship due to the high rate of microbial-resistance in our population.
Authors: J Stuart Wolf; Carol J Bennett; Roger R Dmochowski; Brent K Hollenbeck; Margaret S Pearle; Anthony J Schaeffer Journal: J Urol Date: 2008-02-20 Impact factor: 7.450
Authors: Tommaso Cai; Paolo Verze; Anna Brugnolli; Daniele Tiscione; Lorenzo Giuseppe Luciani; Cristina Eccher; Paolo Lanzafame; Gianni Malossini; Florian M E Wagenlehner; Vincenzo Mirone; Truls E Bjerklund Johansen; Robert Pickard; Riccardo Bartoletti Journal: Eur Urol Date: 2015-05-20 Impact factor: 20.096