Short - versus - long course antibiotics in catheterized patients undergoing transurethral resection of prostate

Orgeness Jasper Mbwambo 1, 3, *, James Samwel Ngocho 2, Emmanuel Mtui 2, Philemon Rune 2, 3, Frank Bright 1, 3 and Alfred Kien Mteta 1, 3

1 Department of Urology, Kilimanjaro Christian Medical University College, Moshi, Tanzania.
2 Department of Epidemiology and Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania.
3 Kilimanjaro Christian Medical Centre, P.O. Box 3010, Moshi, Tanzania.
 
Research Article
World Journal of Advanced Research and Reviews, 2021, 10(03), 173–179
Article DOI: 10.30574/wjarr.2021.10.3.0260
 
Publication history: 
Received on 30 April 2021; revised on 06 June 2021; accepted on 09 June 2021
 
Abstract: 
Introduction: The duration of peri-operative antibiotic treatment for patients undergoing Trans Urethral Resection of the Urostate (TURP) and who have been catheterized pre-operatively, remains undecided. The efficacy of a short-versus a traditional long-course antibiotic regime was investigated in preventing post-operative bacteriuria for catheterized patients undergoing TURP at a single centre.
Methodology: A randomized single blind, single centre clinical trial was conducted between September 2017 and May 2018. Patients were randomized into two groups (1:1). The control group received peri-operative antibiotics for 8 days and the intervention group for 3 days. Urinalysis and urine culture were performed pre-operatively, and post-operatively on day 2 and days 9 to 11, following TURP. All patients were followed up for 30 days after surgery for signs and symptoms of infectious complications.
Results: A total of 83 patients were enrolled in the study. 78 patients were evaluable until day 2 and 66 until days 9 to 11. The incidence of bacteriuria at days 9 to 11 following TURP were 40 % and 38.7% in the intervention (short-course) and control (long-course) groups respectively (RR 1.03, 95% CI 0.097 to 2.573). The incidence of Symptomatic Urinary Tract Infections (UTI) at the same time was 11.4% and 9.7% in intervention and control groups respectively (RR 1.27, 95% CI 0.10 to 2.57). None of the patients enrolled in the study developed clinical sepsis nor required re-admission during the follow up period.
Conclusion: A short- course antibiotic is as effective as a long course in preventing infectious complications in catheterized patients undergoing TURP.
 
Keywords: 
Antibiotic; Catheterized; Prostate surgery; Antimicrobial stewardship
 
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