Double-blinded randomized trial of preoperative antibiotics in midurethral sling procedures and review of the literature

Abstract

The objective of this study was to determine if prophylactic antibiotic use before midurethral sling procedures reduces infectious complications. In this double-blinded randomized trial, we compared infectious complications between women who received cefazolin and placebo before midurethral sling procedures. The study was halted due to low rate of infectious outcomes seen at the first scheduled interim analysis. We enrolled 29 women in the cefazolin group and 30 in the placebo group. Total follow-up was 6 months (3-24 months). The groups were similar at the baseline. There was no statistically significant difference between the cefazolin and placebo groups, respectively, with respect to wound infections [1 (3.3%) and 0 (0%)], mesh exposure [0 (0%) and 1 (3.5%)], and bacteriuria [3 (10%) and 1 (3.5%)]. Because infection rates are low in both cefazolin and placebo groups, omitting preoperative antibiotics for midurethral slings may be justified.