A randomized trial regarding antimicrobial prophylaxis (AMP) in transurethral resection of bladder tumor (TURB).
Aged
Aged, 80 and over
Amikacin
/ therapeutic use
Anti-Bacterial Agents
/ therapeutic use
Antibiotic Prophylaxis
/ methods
Carcinoma, Transitional Cell
/ surgery
Cefazolin
/ therapeutic use
Ciprofloxacin
/ therapeutic use
Cystoscopy
/ methods
Female
Fever
/ epidemiology
Humans
Levofloxacin
/ therapeutic use
Logistic Models
Male
Postoperative Complications
/ epidemiology
Surgical Wound Infection
/ epidemiology
Urinary Bladder Neoplasms
/ surgery
Urinary Tract Infections
/ epidemiology
AMP
Antimicrobial stewardship
Fever
Microbial resistance
RCT
TURB
Journal
World journal of urology
ISSN: 1433-8726
Titre abrégé: World J Urol
Pays: Germany
ID NLM: 8307716
Informations de publication
Date de publication:
Oct 2021
Oct 2021
Historique:
received:
13
03
2021
accepted:
03
04
2021
pubmed:
12
4
2021
medline:
19
2
2022
entrez:
11
4
2021
Statut:
ppublish
Résumé
To determine whether omitting antimicrobial prophylaxis (AMP) in TURB is safe in patients undergoing TURB without an indwelling pre-operative catheter/nephrostomy/DJ and a negative pre-operative urinary culture. A multi-centered randomized controlled trial (RCT) from 17-09-2017 to 31-12-2019 in 5 hospitals. Patients with a pre-operative indwelling catheter/DJ-stent or nephrostomy and a positive pre-operative urinary culture (> 10 459 Patients were included and 202/459 (44.1%) received AMP vs 257/459 (55.9%) without AMP. Fever occurred in 6/202 [2.9%; 95% CI (1.2-6.6%)] patients with AMP vs 8/257 [3.1%; 95% CI (1.5%-6.1%)] without AMP (p = 0.44). Multivariable, logistic regression showed no significant harm in omitting AMP when controlled for (clot-)retention and tumor size (p = 0.85) and an adjusted risk difference in developing post-TURB fever of 0.0016; 95% CI [- 0.029; 0.032]. Our data suggest the safety of omitting AMP in patients undergoing TURB without an indwelling, pre-operative catheter/nephrostomy/DJ and a negative pre-operative urinary culture.
Identifiants
pubmed: 33839918
doi: 10.1007/s00345-021-03694-6
pii: 10.1007/s00345-021-03694-6
doi:
Substances chimiques
Anti-Bacterial Agents
0
Ciprofloxacin
5E8K9I0O4U
Levofloxacin
6GNT3Y5LMF
Amikacin
84319SGC3C
Cefazolin
IHS69L0Y4T
Types de publication
Journal Article
Multicenter Study
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
3839-3844Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
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