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Antimicrobial prophylaxis not required in some patients undergoing TURP: Study
![Antimicrobial prophylaxis not required in some patients undergoing TURP: Study Antimicrobial prophylaxis not required in some patients undergoing TURP: Study](https://medicaldialogues.in/h-upload/2021/06/09/750x450_155673-transurethral-resection-of-the-prostate.webp)
Belgium: Antimicrobial prophylaxis can be safely omitted in patients undergoing transurethral resection of the prostate (TURP) without a preoperative indwelling catheter and pyuria, finds a recent study. The findings are published in The Journal of Urology.
Transurethral resection of the prostate is a surgery used for the treatment of urinary problems caused by an enlarged prostate. The procedure involves the insertion of an instrument called a resectoscope through the tip of the penis into the urthera. The resectoscope helps to examine and trim away excess prostate tissue causing the blockage to urinary flow. It is considered as an option for patients having moderate to severe urinary problems that haven't responded to medication.
Antibiotic prophylaxis is standard procedure in TURP. It is used widely to protect patients from infectious complications of invasive procedures, including surgical site infections (SSIs). However, there has been a growing trend to minimize antibiotic usage to reduce the development of resistance from overuse.
Evert Baten, Associatie Urologie Hageland, Tielt-Winge, Belgium, and colleagues sought to determine whether omitting antimicrobial prophylaxis is safe in patients undergoing transurethral resection of the prostate without preoperative pyuria and a preoperative catheter.
For this purpose, the researchers conducted a multicenter randomized controlled trial from September 17, 2017, until December 31, 2019, in 5 hospitals. It excluded patients with pyuria (>100 white blood cells/ml) and a preoperative indwelling catheter
Postoperative fever was defined as a body temperature ≥38.3C. A noninferiority design was used with a 6% noninferiority margin and null hypothesis (H0) that the infection risk is at least 6% higher in the experimental (E) than in the control (C) group; H0: C (antimicrobial prophylaxis group) − E (no antimicrobial prophylaxis group) ≥ Δ (6% noninferiority margin).
Key findings of the study include:
· Of the patients 474 were included for multivariable analysis and 44.5% received antimicrobial prophylaxis vs 55.5% patients without antimicrobial prophylaxis.
· Antibiotics were fluoroquinolones in 66.4% patients, cephazolin in 27.5% and amikacin in 6.2% patients.
· Fever occurred in 4.4% patients with antimicrobial prophylaxis vs 4.9% without antimicrobial prophylaxis.
· The researchers were able to exclude a meaningful increase in harm associated with omitting antimicrobial prophylaxis.
"Our data demonstrate the safety of omitting antimicrobial prophylaxis in patients undergoing transurethral resection of the prostate without preoperative pyuria and a preoperative indwelling catheter," concluded the authors.
Reference:
The study titled, "Antimicrobial Prophylaxis in Transurethral Resection of the Prostate: Results of a Randomized Trial," is published in The Journal of Urology.
DOI: https://www.auajournals.org/doi/10.1097/JU.0000000000001638
MSc. Biotechnology
Medha Baranwal joined Medical Dialogues as an Editor in 2018 for Speciality Medical Dialogues. She covers several medical specialties including Cardiac Sciences, Dentistry, Diabetes and Endo, Diagnostics, ENT, Gastroenterology, Neurosciences, and Radiology. She has completed her Bachelors in Biomedical Sciences from DU and then pursued Masters in Biotechnology from Amity University. She has a working experience of 5 years in the field of medical research writing, scientific writing, content writing, and content management. She can be contacted at  editorial@medicaldialogues.in. Contact no. 011-43720751
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: editorial@medicaldialogues.in. Contact no. 011-43720751