Efficacy of 1 versus 3 days of intravenous amikacin as a prophylaxis for patients undergoing transurethral resection of the prostate: A prospective randomized trial.
| Autor: | Jayanth ST; Department of Urology, Christian Medical College, Vellore, Tamil Nadu, India., Chandrasingh J; Department of Urology, Christian Medical College, Vellore, Tamil Nadu, India., Sahni RD; Department of Microbiology, Christian Medical College, Vellore, Tamil Nadu, India., Mukha RP; Department of Urology, Christian Medical College, Vellore, Tamil Nadu, India., Kumar S; Department of Urology, Christian Medical College, Vellore, Tamil Nadu, India., Devasia A; Department of Urology, Christian Medical College, Vellore, Tamil Nadu, India., Kekre NS; Department of Urology, Christian Medical College, Vellore, Tamil Nadu, India. |
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| Jazyk: | angličtina |
| Zdroj: | Indian journal of urology : IJU : journal of the Urological Society of India [Indian J Urol] 2021 Apr-Jun; Vol. 37 (2), pp. 133-139. Date of Electronic Publication: 2021 Apr 01. |
| DOI: | 10.4103/iju.IJU_494_20 |
| Abstrakt: | Introduction: There are no uniform guidelines on the duration of antibiotic prophylaxis for transurethral resection of the prostate (TURP). The objective of this study was to evaluate the efficacy of 1 day versus 3 days of intravenous amikacin as prophylaxis, before TURP. Materials and Methods: In this prospective randomized control trial, patients with sterile preoperative urine culture were randomized to receive either 1 day (Group A) or 3 days (Group B) of intravenous (IV) amikacin. All patients had their catheter removed on the 3 rd day and a midstream urine culture was obtained on the 4 th day. The follow-up was scheduled at 1 week and at 1 month. The rate of bacteriuria on the 4 th postoperative day was analyzed as the primary outcome. The secondary outcomes included symptomatic urinary tract infection (UTI), its risk factors, and other complications at 1 month. Results: Of the 338 patients randomized, 314 patients were evaluable until day 7 and 307 until 1 month. Bacteriuria rate at day 4 (Group A: 8.8% [95% confidence interval (CI): 4.2-13.2]; Group B: 4.4% [95% CI: 1.2%-7.7%], P = 0.124, Fisher's exact test) was similar in both the groups. At 1 month, the rate of symptomatic UTI was also similar in both the groups (3.5% [95% CI: 0.8-6.9] vs. 1.7% [95% CI: 0.2-4.2], P = 0.344, Fisher's exact test). Bacteriuria (colony-forming unit, >10 4 /ml) at day 4 was a significant risk factor for developing symptomatic UTI ( P = 0.006). Antibiotic resistance was higher in Group B ( P = 0.002) (Group A: 7.1% [95% CI: 6.3-20] vs. Group B: [71%, CI: 38-104], P = 0.0021, Fisher's exact test). Conclusion: One day is possibly noninferior to 3 days of IV amikacin as prophylaxis in patients undergoing TURP with respect to bacteriuria and symptomatic UTI, with an added advantage of lower antibiotic resistance. Competing Interests: Conflicts of interest: There are no conflicts of interest. (Copyright: © 2021 Indian Journal of Urology.) |
| Databáze: | MEDLINE |
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