title: [Antibiotic prophylaxis in urology].
abstract: BACKGROUND
  Antibiotic prophylaxis (AP) is used to minimize infectious complications resulting from interventions. Due to high rates of development of bacterial resistance and side effects, the use of antibiotics must be weighed on the basis of high levels of evidence. The main endpoints of urology AP are the prevention of symptomatic urogenital infections, urosepsis and wound infections. The purpose of this review is to bring objectives, principles and recommendations on urology AP according to the latest scientific evidence.
  
  
  METHODS
  We carried out a systematic search of MEDLINE, EMBASE and the Cochrane Library using keywords such as AP, prophylaxis, antibiotics, urological surgery, urogenital surgery and the names of the urologic procedures. The results of studies on the AP for each procedure were classified according to the levels of evidence and grades of recommendation from the European Association of Urology.
  
  
  RESULTS
  There are a number of good quality studies on AP about endoscopic resection of the prostate (TURP), urodynamic studies and transrectal prostate biopsies (trPB). The majority of the studies about other procedures have several limitations (sample size, consistency of definitions, statistics and trial design). Lack of consistency in the definitions of infectious complications does not allow comparison between different studies.
  
  
  CONCLUSIONS
  The AP is evidence-based is indicated only for TURP and trPB. It is desirable to perform randomized, prospective and controlled trials in order to rationalize the use of antibiotics, improve the cost/benefit ratio and reduce bacterial antibiotic resistances.
authors.affiliation: Clinica Urologica, Policlinico "A. Gemelli", Università Cattolica del Sacro Cuore, Roma - Italy.
authors.forename: Salvatore Marco
authors.initials: SM
authors.lastname: Recupero
authors.forename: Riccardo
authors.initials: R
authors.lastname: Bientinesi
authors.forename: Nazario
authors.initials: N
authors.lastname: Foschi
authors.forename: Marco
authors.initials: M
authors.lastname: Racioppi
authors.forename: Pier Francesco
authors.initials: PF
authors.lastname: Bassi
authors.forename: Emilio
authors.initials: E
authors.lastname: Sacco
mesh_terms: D019072:Antibiotic Prophylaxis / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D017410:Practice Guidelines as Topic; D020728:Transurethral Resection of Prostate / Q000009:adverse effects; D016896:Treatment Outcome; D014552:Urinary Tract Infections / Q000382:microbiology / Q000517:prevention & control*; D013520:Urologic Surgical Procedures / Q000009:adverse effects; D014572:Urology; D014946:Wound Infection / Q000517:prevention & control*