Systematic Review of Antibiotic Prophylaxis for Postoperative Bacteriuria in Men Undergoing TURP_Chinese Journal of Evidence-Based Medicine

Authors：

WU Jianchen ¹ , WEI Qiang ¹ , YANG Yuru ¹ , LIU Guanjian ² , LU Yiping ¹

1. Department of Urology; West China Hospital; Sichuan University; Chengdu 610041; China2. Department of Clinical Epidemiology; Sichuan University; Chengdu 610041; China;

Corresponding author：

Keywords：

Prostatic hyperplasia; Transurethral resection of prostate; Antibiotic prophylaxis; Systematic review

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Objective 　To determine whether antibiotic prophylaxis can reduce the risk of postoperative bacteriuria in men undergoing transurethral resection of prostate (TURP) who have sterile preoperative urine.
Method 　MEDLINE, EMBASE and Cochrane Library were searched for RCTs comparing antibiotic prophylaxis and placebo/blank controls for men undergoing TURP with preoperative sterile urine. The search strategy was established according to the Cochrane Prostatic Diseases and Urologic Cancers Group search strategy. Data was extracted by two reviewers using the designed extraction form. RevMan were used for data management and analysis.
Results 　Fifty three relevant trials were searched, of which 27 trials were included and 26 were excluded. Antibiotic prophylaxis significantly decreased the rate of post-TURP bacteriuria.The pooled relative risk (RR) and 95% confidence interval were 0.36 (0.28, 0.46).
Conclusions 　Prophylactic antibiotics could significantly decrease the incidence of post-TURP bacteriuria. Further comparative RCTs and cost-effective should be performed analysis to establish the optimal antibiotic regimes for the benefit of patients undergoing TURP.

Citation： WU Jianchen,WEI Qiang,YANG Yuru,LIU Guanjian,LU Yiping. Systematic Review of Antibiotic Prophylaxis for Postoperative Bacteriuria in Men Undergoing TURP. Chinese Journal of Evidence-Based Medicine, 2004, 04(2): 98-103. doi: Copy

1.	［1］Holtgrewe HL. Current trends in management of men with lower urinary tract symptoms and benign prostatic hyperplasia[J]. Urology, 1998; 51(Suppl 4A):1-7.
2.	［2］Mebust WK, Holtgrewe HL, Cockett AT, Peters PC.Transurethral prostatectomy: immediate and postoperative complications. Cooperative study of 13 participating institutions evaluating 3 885 patients[J]. J Urol., 2002; 167(1) :5-9.
3.	［3］Mulrow CD, Oxman AD. The Cochrane Collaboration handbook, Issue 1,2000,Oxford,Update Software.
4.	［4］Bannister G, Arkell DG and Menday AP. Prostatectomy and prophylaxis[J]. J Antimicrob Chemother, 1981; 7 (2): 209-210.
5.	［5］Botto H, Richard F, Mathieu F, Perreau AM, Camey M.Short-Vterm proohylaxis with cefotaxime in prostatic surgery[J]. J Antimicrob Chemother, 1984; 14 (Suppl B) :231-235.
6.	［6］Charton M, Dosne B, Escovar P, Kopf A, Brisset JM. Single Vdose preventive treatment of urinary tract infections after endoscopic resection of the prostate [J ]. Presse Med., 1984;13(9): 545-548.
7.	［7］Charton M, Vallancien G, Veillon B, Brisset JM. Antibiotic prophylaxis of urinary tract infection after transurethral resection of the prostate: A randomized study[J]. J Urol., 1987; 138(1) :87-89.
8.	［8］Conn IG, Moffat LE. Short-term cephradine prophylaxis in elective transurethral prostatectomy [ J ]. J Hosp Infect, 1988;11 (4): 373-375.
9.	［9］Desai KM, Abrams PH, White LO. A double Vblind comparative trial of short Vterm orally administered enoxacin in the prevention of urinary infection after elective transurethral prostatectomy: A clinical and pharmacokinetic study [J ]. J Urol., 1988; 139(6):1232V1234.
10.	［10］Fair WB. Perioperative use of carbenicillin in transurethral resection ofprostate[J]. J Urol., 1986;272 (Suppl 1) :15-18.
11.	［11］Ferrie BG, Scott R. Prophylactic Cefuroxime in transurethral resection[J]. Urol Res, 1984 ;12 (6): 279-281.
12.	［12］Finkelstein LH, Arsht DB, Manfrey SJ, Childs S. Ceftriaxone in the prevention of postoperative infection in patients undergoing transurethral resection of the prostate [ J ]. Am J Surg, 1984;19(4A): 19-21.
13.	［13］Gibbons RP, Stark RA, Correa RJJr, Cummings KB,Mason JT. The prophylactic use-or misuse-of antibiotics in transurethral prostatectomy[J]. J Urol., 1978 ;119(3): 381-383.
14.	［14］Gonzalez R, Wright R, Blackard CE. Prophylactic antibiotics in transurethral prostatectomy[J ]. J Urol., 1976; 116 (2) :203-205.
15.	［15］Hargreave TB, Botto H, Rikken GH, Hindmarsh JR,Mc Dermott TE, Mjolnerod OK,Petays P, Schalkhauser HK,Stellos A. European collaborative study of antibiotic prophylaxis for transurethral resection of the prostate[J ]. Eur Urol, 1993; 23(4): 437443.
16.	［16］Harvey MH, Leese T, Lloyd D, Osborn DE. Antibiotic prophylaxis and secondary haemorrhage following transurethral resection of the prostate: a prospective trial [J ]. Br J Urol.,1986; 58(4): 450-452.
17.	［17］Holl WH, Rous SN. Is antibiotic prophylaxis worthwhile in patients with transurethral resection of prostate[J] ? Urology,1982 ;19(1): 43-46.
18.	［18］Houle AM, Mokhless I, Sarto N, Elhilali MM. Perioperative antibiotic prophylaxis for transurethral resection of the prostate:is it justifiable[J] ? J Urol., 1989; 142(2 pt 1): 317-319.
19.	［19］Matthew AD, Gonzalez R, Jeffords D, Pinto MH. Prevention of bactefiuria after transurethral prostatectomy with nitrofurantoin macrocrystals[J ]. J Urol., 1978; 120 (4):442-443.
20.	［20］Morris MJ, Golovsky D, Guinness MD, Maher PO. The value of prophylactic antibiotics in tranurethral prostatic resection: a controlled trial, with observations on the origin of postoperative infection [J ]. Br J Urol., 1976; 48 (6):479V484.
21.	［21］Nielsen OS, Maigaard S, Frimodt-Moller N, Madsen PO.Prophylatic antibiotics in transurethral prostatectomy [ J ]. J Urol., 1981 ;126(1) :60-62.
22.	［22］Qvist N, Christiansen HM, Ehlers D. Prophylactic antibiotics in transurethral prostatectomy[J ]. Urol Res, 1984; 12 (6) :275-277.
23.	［23］Raz R, Almog D, Elhanan G, Shental J. The use of ceftriaxone in the prevention of urinary tract infection in patients undergoing transurethral resection of the prostate (TUR-P)[J]. Infection, 1994; 22(5): 347-349.
24.	［24］Rocca Rossetti S, Boccafoschi C, Pellegrini A, Campo B,Rigatti P, Bono A,Ventriglia L. Aztreonam Hmonotherapy as prophylaxis in transurethral resection of the prostate: a multicentre study [ J ]. Rev Infect Dis, 1991; 13 (Suppl 7):626-628.
25.	［25］Scholz M, Luftenegger W, Hanmuth H, Wolf D, Holtl W.Single-dose antibiotic prophylaxis in transurethral resection of the prostate: a prospective randomized trial[ J ]. Br J Urol.,1998; 81 (6): 827-329.
26.	［26］Slavis SA, Miller JB, Golji H, Dunshee CJ. Comparison of single-dose antibiotic prophylaxis in uncomplicated transurethral resection of the prostate [ J ]. J Urol., 1992; 147 (5): 1303-1306.
27.	［27］Stricker PD, Grant AB. Relative value of antibiotics and catheter care in the prevention of urinary tract infection after transurethral prostatic resection [J]. Br J Urol., 1988; 61(6): 494-497.
28.	［28］Taylor EW, Lindsay G. Antibiotic prophylaxis in transurethral resection of the prostate with reference to the influence of preoperative catheterization [J ]. J Hosp Infect. 1988; 12 (2):75-83.
29.	［29］Viitanen J, Talja M, Jussila E, Nurmi M, Permi J, Puolakka VM, Rintala E, Salmela H, Tiitinen J, Tuhkanen K.Randomized controlled study of chemoprophylaxis in transurethral prostatectomy[J]. J Urol., 1993; 1505 (Pt 2):1715-1717.
30.	［30］Weiss J, Wein A, Jacobs J, Hanno P. Use of nitrofurantoin macrocrystals after transurethral prostatectomy [ J ]. J Urol.,1983; 130(3) :479-480.
31.	［31］Robinson MR, Arudpragasam ST, Sahgal SM, Cross RJ,Akdas A, Fittal B, Sibbald R. Bacteremia resulting from prostatic surgery: The sourse of bacteria [ J ]. Br. J Urol.,1982; 54(5): 542-546.
32.	［32］Grabe M. Short antibiotic courses in transurethral prostatic resection. Scand J Urol. Nephrol, 1984 ;78 (1) :4.
33.	［33］Wear JB, Haley P. transurethral prostatectomy without antibiotics[J]. J Urol., 1973; 110(4): 436-440.
34.	［34］Robinson MR, Cross RJ, Shetty MB, Fittall B. Bacteraemia and bacteriogenic shock in district hospital urologocal practice[J]. Br J Urol., 1980; 52(1): 10-14.
35.	［35］Balbay MD, Ergen A, Sahin A, Lekili M, Ulucay S,Karaagaoglu E. Development of urethral stricture after transurethral prostatectomy: a retrospective study [ J ]. Int Urol. Nephol, 1992; 24(1): 49-53.

1. ［1］Holtgrewe HL. Current trends in management of men with lower urinary tract symptoms and benign prostatic hyperplasia[J]. Urology, 1998; 51(Suppl 4A):1-7.
2. ［2］Mebust WK, Holtgrewe HL, Cockett AT, Peters PC.Transurethral prostatectomy: immediate and postoperative complications. Cooperative study of 13 participating institutions evaluating 3 885 patients[J]. J Urol., 2002; 167(1) :5-9.
3. ［3］Mulrow CD, Oxman AD. The Cochrane Collaboration handbook, Issue 1,2000,Oxford,Update Software.
4. ［4］Bannister G, Arkell DG and Menday AP. Prostatectomy and prophylaxis[J]. J Antimicrob Chemother, 1981; 7 (2): 209-210.
5. ［5］Botto H, Richard F, Mathieu F, Perreau AM, Camey M.Short-Vterm proohylaxis with cefotaxime in prostatic surgery[J]. J Antimicrob Chemother, 1984; 14 (Suppl B) :231-235.
6. ［6］Charton M, Dosne B, Escovar P, Kopf A, Brisset JM. Single Vdose preventive treatment of urinary tract infections after endoscopic resection of the prostate [J ]. Presse Med., 1984;13(9): 545-548.
7. ［7］Charton M, Vallancien G, Veillon B, Brisset JM. Antibiotic prophylaxis of urinary tract infection after transurethral resection of the prostate: A randomized study[J]. J Urol., 1987; 138(1) :87-89.
8. ［8］Conn IG, Moffat LE. Short-term cephradine prophylaxis in elective transurethral prostatectomy [ J ]. J Hosp Infect, 1988;11 (4): 373-375.
9. ［9］Desai KM, Abrams PH, White LO. A double Vblind comparative trial of short Vterm orally administered enoxacin in the prevention of urinary infection after elective transurethral prostatectomy: A clinical and pharmacokinetic study [J ]. J Urol., 1988; 139(6):1232V1234.
10. ［10］Fair WB. Perioperative use of carbenicillin in transurethral resection ofprostate[J]. J Urol., 1986;272 (Suppl 1) :15-18.
11. ［11］Ferrie BG, Scott R. Prophylactic Cefuroxime in transurethral resection[J]. Urol Res, 1984 ;12 (6): 279-281.
12. ［12］Finkelstein LH, Arsht DB, Manfrey SJ, Childs S. Ceftriaxone in the prevention of postoperative infection in patients undergoing transurethral resection of the prostate [ J ]. Am J Surg, 1984;19(4A): 19-21.
13. ［13］Gibbons RP, Stark RA, Correa RJJr, Cummings KB,Mason JT. The prophylactic use-or misuse-of antibiotics in transurethral prostatectomy[J]. J Urol., 1978 ;119(3): 381-383.
14. ［14］Gonzalez R, Wright R, Blackard CE. Prophylactic antibiotics in transurethral prostatectomy[J ]. J Urol., 1976; 116 (2) :203-205.
15. ［15］Hargreave TB, Botto H, Rikken GH, Hindmarsh JR,Mc Dermott TE, Mjolnerod OK,Petays P, Schalkhauser HK,Stellos A. European collaborative study of antibiotic prophylaxis for transurethral resection of the prostate[J ]. Eur Urol, 1993; 23(4): 437443.
16. ［16］Harvey MH, Leese T, Lloyd D, Osborn DE. Antibiotic prophylaxis and secondary haemorrhage following transurethral resection of the prostate: a prospective trial [J ]. Br J Urol.,1986; 58(4): 450-452.
17. ［17］Holl WH, Rous SN. Is antibiotic prophylaxis worthwhile in patients with transurethral resection of prostate[J] ? Urology,1982 ;19(1): 43-46.
18. ［18］Houle AM, Mokhless I, Sarto N, Elhilali MM. Perioperative antibiotic prophylaxis for transurethral resection of the prostate:is it justifiable[J] ? J Urol., 1989; 142(2 pt 1): 317-319.
19. ［19］Matthew AD, Gonzalez R, Jeffords D, Pinto MH. Prevention of bactefiuria after transurethral prostatectomy with nitrofurantoin macrocrystals[J ]. J Urol., 1978; 120 (4):442-443.
20. ［20］Morris MJ, Golovsky D, Guinness MD, Maher PO. The value of prophylactic antibiotics in tranurethral prostatic resection: a controlled trial, with observations on the origin of postoperative infection [J ]. Br J Urol., 1976; 48 (6):479V484.
21. ［21］Nielsen OS, Maigaard S, Frimodt-Moller N, Madsen PO.Prophylatic antibiotics in transurethral prostatectomy [ J ]. J Urol., 1981 ;126(1) :60-62.
22. ［22］Qvist N, Christiansen HM, Ehlers D. Prophylactic antibiotics in transurethral prostatectomy[J ]. Urol Res, 1984; 12 (6) :275-277.
23. ［23］Raz R, Almog D, Elhanan G, Shental J. The use of ceftriaxone in the prevention of urinary tract infection in patients undergoing transurethral resection of the prostate (TUR-P)[J]. Infection, 1994; 22(5): 347-349.
24. ［24］Rocca Rossetti S, Boccafoschi C, Pellegrini A, Campo B,Rigatti P, Bono A,Ventriglia L. Aztreonam Hmonotherapy as prophylaxis in transurethral resection of the prostate: a multicentre study [ J ]. Rev Infect Dis, 1991; 13 (Suppl 7):626-628.
25. ［25］Scholz M, Luftenegger W, Hanmuth H, Wolf D, Holtl W.Single-dose antibiotic prophylaxis in transurethral resection of the prostate: a prospective randomized trial[ J ]. Br J Urol.,1998; 81 (6): 827-329.
26. ［26］Slavis SA, Miller JB, Golji H, Dunshee CJ. Comparison of single-dose antibiotic prophylaxis in uncomplicated transurethral resection of the prostate [ J ]. J Urol., 1992; 147 (5): 1303-1306.
27. ［27］Stricker PD, Grant AB. Relative value of antibiotics and catheter care in the prevention of urinary tract infection after transurethral prostatic resection [J]. Br J Urol., 1988; 61(6): 494-497.
28. ［28］Taylor EW, Lindsay G. Antibiotic prophylaxis in transurethral resection of the prostate with reference to the influence of preoperative catheterization [J ]. J Hosp Infect. 1988; 12 (2):75-83.
29. ［29］Viitanen J, Talja M, Jussila E, Nurmi M, Permi J, Puolakka VM, Rintala E, Salmela H, Tiitinen J, Tuhkanen K.Randomized controlled study of chemoprophylaxis in transurethral prostatectomy[J]. J Urol., 1993; 1505 (Pt 2):1715-1717.
30. ［30］Weiss J, Wein A, Jacobs J, Hanno P. Use of nitrofurantoin macrocrystals after transurethral prostatectomy [ J ]. J Urol.,1983; 130(3) :479-480.
31. ［31］Robinson MR, Arudpragasam ST, Sahgal SM, Cross RJ,Akdas A, Fittal B, Sibbald R. Bacteremia resulting from prostatic surgery: The sourse of bacteria [ J ]. Br. J Urol.,1982; 54(5): 542-546.
32. ［32］Grabe M. Short antibiotic courses in transurethral prostatic resection. Scand J Urol. Nephrol, 1984 ;78 (1) :4.
33. ［33］Wear JB, Haley P. transurethral prostatectomy without antibiotics[J]. J Urol., 1973; 110(4): 436-440.
34. ［34］Robinson MR, Cross RJ, Shetty MB, Fittall B. Bacteraemia and bacteriogenic shock in district hospital urologocal practice[J]. Br J Urol., 1980; 52(1): 10-14.
35. ［35］Balbay MD, Ergen A, Sahin A, Lekili M, Ulucay S,Karaagaoglu E. Development of urethral stricture after transurethral prostatectomy: a retrospective study [ J ]. Int Urol. Nephol, 1992; 24(1): 49-53.

Chinese Journal of Evidence-Based Medicine

Systematic Review of Antibiotic Prophylaxis for Postoperative Bacteriuria in Men Undergoing TURP

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