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Study of Appropriate Antibiotic Therapy in Transurethral Prostatectomy
Author(s) -
KIELY E. A.,
McCORMACK T.,
CAFFERKEY M. T.,
FALKINER F. R.,
BUTLER M. R.
Publication year - 1989
Publication title -
british journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 0007-1331
DOI - 10.1111/j.1464-410x.1989.tb05523.x
Subject(s) - antibiotic therapy , medicine , prostatectomy , urology , antibiotics , prostate , microbiology and biotechnology , biology , cancer
Summary— Septicaemia is the commonest cause of morbidity and mortality following transurethral prostatectomy. Routine blind antibiotic prophylaxis is not always effective and there is a tendency to over‐use potent new and expensive antimicrobials. Attempts to “sterilise” the urine pre‐operatively are also expensive and disruptive. However, appropriate treatment/prophylaxis can be administered economically using rapidly obtained laboratory results. We describe here a technique of routine direct antibiotic sensitivity testing (DST) of the patient's urine pre‐operatively and before catheter removal. Such testing can be performed by junior medical staff in a ward side‐room. An appropriate antibiotic may then be administered parenterally 1 h before surgery or catheter removal. A total of 102 consecutive patients underwent TURP and only 1 of those with infected urine became septicaemic. In this instance, an appropriate antibiotic had been incorrectly given orally before removal of the catheter. If the antibiotic sensitivities of a patient's urine are known, and an appropriate antibiotic is given parenterally 1 h pre‐operatively or before catheter removal, the incidence of septicaemia following transurethral surgery may be significantly reduced.