Effect of Antibiotic Prophylaxis on Infectious Complications in Patients with Asymptomatic Bacteriuria Undergoing Urologic Surgery

• Main Authors: Jorge A. Ramos-Castaneda, Alberto Ruano-Ravina, Javier Osorio-Manrique, Jackeline Barreto-Mora, Angela María Segura-Cardona, Elkin V. Lemos-Luengas
• Format: Article
• Language: English
• Published: Thieme Revinter Publicações 2021-09-01
• Series: Urología Colombiana
• Subjects: asymptomatic bacteriuria; urinary tract infection; bacteremia; sepsis; surgical wound infection; urologic surgical procedures; urologic surgery
• Online Access: http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1730320
• ISSN: 0120-789X; 2027-0119

Objectives To identify the effect of duration of surgical antibiotic prophylaxis (SAP) and other variables on infectious postsurgical complications in patients with asymptomatic bacteriuria (ASB) undergoing urological surgery. Methods We conducted an observational study of a cohort of patients with ASB scheduled for urologic surgery at three health service providers in Colombia. The study population comprised all patients with planned urologic surgery who had ASB prior to surgery from April 2018 to January 2019. The intervention evaluated was the duration of preoperative SAP, and the outcome variable was the development of any postoperative infectious complications for up to 30 days after the procedure. Results The present study included 184 patients with ASB scheduled for urologic surgery. The median duration of preoperative SAP (p = 0.49) or of 1 dose SAP (risk ratio [RR] = 1.24; 95% confidence interval [CI]: 0.45–3.39) were not statistically different in patients with postsurgical infectious complications. Infectious complications were more frequent among patients with benign prostatic hyperplasia (RR = 6.57; 95%CI: 1.98–21.76) and hospitalization in the preceding 3 months (RR = 8.32; 95%CI: 2.69–25.71). Conclusion One dose of antimicrobial therapy is sufficient to avoid infectious complications in patients with ASB. There were other factors associated with postsurgical infectious complications, such as benign prostatic hyperplasia and hospitalization in the preceding 3 months.