Abstract
Duration of treatment of asymptomatic bacteriuria for patients undergoing urologic surgical procedures is undetermined. We compared the efficacy of long- versus short-course antimicrobial treatment in patients with asymptomatic bacteriuria undergoing urologic surgical procedures. Patients were divided into two groups according to duration of antimicrobial treatment. Group A patients received a single dose of an appropriate antibiotic, determined by antimicrobial sensitivity testing, 30 to 60 minutes before the surgical procedure. If a urinary catheter was placed postoperatively, a second dose was given following the recommended dose interval. Group B patients received antimicrobial treatment prior to surgery at least until patient urine became sterile. All patients were monitored for signs and symptoms of septicemia following surgical procedures. None of the patients enrolled in the study developed infectious complications such as sepsis or upper urinary tract infection. In group A, 31 patients were treated with antimicrobials before 39 urological procedures. In group B, the mean treatment time for 28 patients before 30 urological procedures was 8.03 ± 3.86 days. There were also significant differences in length of stay and the cost of antimicrobial therapy between the groups (P < 0.0001). Isolation of an increased number of resistant microorganisms was associated with long course therapy in group B. Short course therapy protocol may be a practical, simple approach for antibiotic use; it decreases hospital stays, eliminates delayed procedure times, lowers the economic cost of antimicrobials and lessens the chance of superinfection with and spread of antimicrobial resistant microorganisms.
Highlights
Duration of treatment of asymptomatic bacteriuria for patients undergoing urologic surgical procedures is undetermined
During the study period, none of the patients enrolled in either group developed infectious complications such as sepsis or upper urinary tract infection
Because of the frequent occurrence of extended-spectrum beta-lactamase (ESBL) producing E. coli, K. pneumoniae and inducible beta-lactamase (IBL) producing P. aeruginosa at 60.5% (23/38), 83.3% (10/12) and 90% (9/10) respectively, imipenem was the most frequently selected antimicrobial agent used in both groups
Summary
Duration of treatment of asymptomatic bacteriuria for patients undergoing urologic surgical procedures is undetermined. We compared the efficacy of long- versus short-course antimicrobial treatment in patients with asymptomatic bacteriuria undergoing urologic surgical procedures. Conclusions: Short course therapy protocol may be a practical, simple approach for antibiotic use; it decreases hospital stays, eliminates delayed procedure times, lowers the economic cost of antimicrobials and lessens the chance of superinfection with and spread of antimicrobial resistant microorganisms. Preoperative bacteriuria was shown to increase the severe infectious complications such as bacteremia, septicemia, and upper urinary tract infection, especially following various urological interventions [3,4,5,6]. The aim of the present study was to compare the effect of long-term versus short-course antimicrobial treatment in patients with asymptomatic bacteriuria undergoing specific urologic surgical procedures
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