title: Surgical site infections may be reduced by shorter duration of prophylactic antibiotic medication in urological surgeries.
abstract: In this study, we investigated whether the occurrence of surgical site infection (SSI) could be decreased by a shorter duration of prophylactic antibiotic medications. Prophylactic antibiotic selection was a 1st or 2nd generation cephalosporin or sulbactam/ampicillin for 2 days for open surgery, laparoscopic surgery, transurethral lithotripsy (TUL), and transurethral resection of the prostate (TURP) as a rule, and 1 day for transurethral surgery other than TUL and for extracorporeal shock wave lithotripsy (ESWL). The kind of prophylactic antibiotics used was switched every 4 months in a year. Three patients had SSI out of the total 389 surgeries included in this study (0.77%). One had pyelonephritis after ESWL, one had urinary tract infection (UTI) after transurethral cutting and coagulation of bladder diverticulum, and one had UTI after TURP. There was no significant difference related to the kind of antibiotics used. However, the SSI occurrence was significantly lower than in the control group in which no definite intervention was performed with longer trends of prophylactic antibiotic usage (14/362, 3.87%) (P=0.0111). In conclusion, we performed 389 urological surgeries with significantly decreased SSI rates using a shorter duration of prophylactic antibiotic medications than in the control group. The results indicate that this method might reduce the occurrence of SSI in urological surgeries.
authors.affiliation: Division of Urology, Department of Organs Therapeutics, Faculty of Medicine, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan. katsumiatlanta@hotmail.com
authors.forename: Katsumi
authors.initials: K
authors.lastname: Shigemura
authors.forename: Soichi
authors.initials: S
authors.lastname: Arakawa
authors.forename: Masuo
authors.initials: M
authors.lastname: Yamashita
authors.forename: Tomihiko
authors.initials: T
authors.lastname: Yasufuku
authors.forename: Masato
authors.initials: M
authors.lastname: Fujisawa
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D019072:Antibiotic Prophylaxis / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013407:Sulbactam / Q000008:administration & dosage; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000517:prevention & control*; D013997:Time Factors; D013520:Urologic Surgical Procedures / Q000009:adverse effects*; D055815:Young Adult; D047090:beta-Lactams / Q000008:administration & dosage
chemical_list: D000900:Anti-Bacterial Agents; D047090:beta-Lactams; D013407:Sulbactam