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Cutting off antimicrobial prophylaxis safe in some TURP cases: Study
![Cutting off antimicrobial prophylaxis safe in some TURP cases: Study Cutting off antimicrobial prophylaxis safe in some TURP cases: Study](https://medicaldialogues.in/h-upload/2021/06/09/750x450_155673-transurethral-resection-of-the-prostate.webp)
Belgium: Omitting antimicrobial prophylaxis is safe in patients undergoing transurethral resection of the prostate without preoperative pyuria and a preoperative indwelling catheter, according to results from a randomized trial published in The Journal of Urology.
The study was conducted by E. Baten, Associatie Urologie Hageland, Tielt-Winge, Belgium, and colleagues with an objective to determine the safety of antimicrobial prophylaxis omission in patients undergoing transurethral resection of the prostate without preoperative pyuria and a preoperative catheter in a multicenter randomized controlled trial from September 17, 2017, until December 31, 2019, in 5 hospitals.
Patients with pyuria (>100 white blood cells/ml) and a preoperative indwelling catheter were excluded. Postoperative fever was defined as a body temperature ≥38.3C. The researchers used a non-inferiority design with a 6% noninferiority margin and the 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).
They also performed a multivariable, logistic regression regarding post transurethral resection of the prostate fever and antimicrobial prophylaxis with co-variates: (clot-)retention and operating time.
Salient findings of the study include:
· Of the patients 474 were included for multivariable analysis and 211/474 (44.5%) received antimicrobial prophylaxis vs 263/474 (55.5%) patients without antimicrobial prophylaxis.
· Antibiotics were fluoroquinolones in 140/211 (66.4%), cephazolin in 58/211 (27.5%) and amikacin in 13/211 (6.2%) patients.
· Fever occurred in 9/211 (4.4%) patients with antimicrobial prophylaxis vs 13/263 (4.9%) without antimicrobial prophylaxis.
· The researchers were able to exclude a meaningful increase in harm associated with omitting antimicrobial prophylaxis.
"Our findings show the safety of omitting antimicrobial prophylaxis in patients undergoing transurethral resection of the prostate without preoperative pyuria and a preoperative indwelling catheter," the researchers concluded.
Reference:
The study titled, "Antimicrobial Prophylaxis in Transurethral Resection of the Prostate: Results of a Randomized Trial," was published in The Journal of Urology.
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