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

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.