Incidence of perioperative urinary tract infection after single-dose antibiotic therapy for midurethal slings.
OBJECTIVE
A recent Best Practice Statement published by the American Urological Association (AUA) recommends that antibiotic therapy in patients undergoing midurethral synthetic slings (MUS) should be 24 hours or less. Subjects at our institution are routinely administered a single dose of intravenous antibiotics before MUS surgery. We prospectively evaluated urinary tract infection (UTI) rates and risk factors for UTI in subjects undergoing MUS who receive single-dose antibiotic therapy.


METHODS
Adult female patients who were undergoing MUS for stress or mixed urinary incontinence were prospectively included and received a single-dose of an intravenous antibiotic in accordance with the AUA Best Practice Statement. Subjects requiring additional procedures for prolapse were excluded. Baseline characteristics and preoperative and postoperative postvoid residual (PVR) were documented. Subjects were contacted within 1 week of surgery, and seen in the office at 1 month, when a urinalysis was performed, and urine culture sent if subjects were symptomatic.


RESULTS
A total of 101 subjects underwent solitary MUS and received a single dose of intravenous antibiotics. Overall, 6 (5.9%) subjects developed a UTI within 1 month of surgery. Patients who developed a UTI were more likely to have elevated PVRs at the preoperative office visit (62.2 vs 26.8 mL, P = .004).


CONCLUSIONS
Our study has demonstrated that the rate of perioperative UTI after MUS with one perioperative dose of intravenous antibiotics is low. Patients with an elevated preoperative PVR may be at an increased risk of developing a UTI. Single-dose antibiotic administration is safe and effective at preventing perioperative UTI in subjects undergoing solitary MUS.
Ingber
Michael S
MS
Center for Female Pelvic Medicine and Reconstructive Surgery, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA. ingbermd@aol.com
Vasavada
Sandip P
SP
Firoozi
Farzeen
F
Goldman
Howard B
HB
D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D002437:Cefazolin / Q000008:administration & dosage / Q000627:therapeutic use; D015897:Comorbidity; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D011182:Postoperative Care; D011183:Postoperative Complications / Q000453:epidemiology* / Q000517:prevention & control; D019919:Prosthesis Implantation; D014546:Urinary Catheterization / Q000009:adverse effects; D014549:Urinary Incontinence / Q000453:epidemiology / Q000601:surgery*; D016055:Urinary Retention / Q000453:epidemiology; D014552:Urinary Tract Infections / Q000453:epidemiology* / Q000517:prevention & control
D000900:Anti-Bacterial Agents; D002437:Cefazolin