Performance of Perioperative Antibiotic Prophylaxis in Operative Urology

Abstract

Introduction. Currently, the question of the need for perioperative antibiotic prophylaxis (PAP) during urological operations remains debatable due to the insufficiency of the database that would prove the expediency of mandatory use of PAP to prevent the development of infectious complications in the surgical treatment of urological diseases. The aim of this study was to assess the effect of perioperative antibiotic prophylaxis on the frequency of febrile temperature, leukocytosis, increased serum levels of C-reactive protein, and bacteriuria after various urological interventions. Patients and methods. Method of the study was the analysis of the occurrence of febrile temperature, leukocytosis, increased serum concentration of C-reactive protein, and bacteriuria in the early period after various urological interventions (n=1518) performed in men and women from group 1 (n=753) using perioperative antibiotic prophylaxis (ceftriaxone administered intravenously one hour before the beginning of the intervention (before the incision) at the usual therapeutic dose, equal to 2 g) or without the use of PAP in patients from group 2 (n=765) at the Department of Urology of the St. Petersburg State Budgetary Healthcare Institution St. Luke’s Clinical Hospital. Results. In urological patients treated surgically, the appearance in the early postoperative period of bacteriuria, febrile temperature, leukocytosis, and elevated serum CRP levels was observed only in isolated cases with a frequency of occurrence that did not statistically significantly differ between group 1, where patients were injected intravenously with 2 grams of ceftriaxone 1 hour before the operation, and group 2, the participants of which did not receive PAP. In both groups, the results of the study were not affected by the duration of the intervention and the history of diseases contributing to the development of infectious complications (diabetes mellitus, chronic heart failure, COPD, obesity). Conclusion. Apparently, the question of indications for perioperative antibiotic prophylaxis in the surgical treatment of patients with various diseases of the urological profile remains open, and further research in this direction is relevant.