PD18-01 ANTIMICROBIAL PROPHYLAXIS (AMP) IN TRANSURETHRAL RESECTION OF THE PROSTATE (TURP): RESULTS OF A RANDOMIZED TRIAL

Abstract

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology III (PD18)1 Sep 2021PD18-01 ANTIMICROBIAL PROPHYLAXIS (AMP) IN TRANSURETHRAL RESECTION OF THE PROSTATE (TURP): RESULTS OF A RANDOMIZED TRIAL Evert Baten, Frank van der Aa, Hans Goethuys, Koen Slabbaert, Ingrid Arijs, and Koen van Renterghem Evert BatenEvert Baten More articles by this author , Frank van der AaFrank van der Aa More articles by this author , Hans GoethuysHans Goethuys More articles by this author , Koen SlabbaertKoen Slabbaert More articles by this author , Ingrid ArijsIngrid Arijs More articles by this author , and Koen van RenterghemKoen van Renterghem More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002007.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: To determine whether omitting antimicrobial prophylaxis (AMP) in TURP is safe in patients undergoing TURP without pre-operative pyuria and a pre-operative catheter. METHODS: A multi-centered randomized controlled trial (RCT) from 17-09-2017 until 31-12-2019 in 5 hospitals. Patients with pyuria (> 100 white blood cells (WBC)/mL)) and a pre-operative, indwelling catheter were excluded. Post-operative fever was defined as a body temperature ≥ 38.3°C. A non-inferiority design with a 6% noninferiority margin and null hypothesis (H0) that the infection risk is at least 6% higher in the experimental (E) than in the control (C) group; H0: C (AMP-group) − E (no AMP-group) ≥ Δ (6% noninferiority margin). A multivariable, logistic regression was performed regarding post-TURP fever and AMP with co-variates: (clot-)retention and operating time. The R Project® for statistical computing was used and a p value of 0.05 was considered as statistically significant. RESULTS: 474 Patients were included for multivariable analysis and 211/474 (44.5%) received AMP vs 263/474 (55.5%) patients without AMP. Antibiotics were fluoroquinolones in 140/211 (66.4%), cephazolin in 58/211 (27.5%) and amikacin in 13/211 (6.2%) patients. Fever occurred in 9/211 (4.4%) patients with AMP vs 13/263 (4.9%) without AMP (p 0.8, risk difference (RD) 0.006 (95% CI [-0.003; 0.06], relative risk (RR) 1.16)). We were able to exclude a meaningful increase in harm associated with omitting AMP (p 0.4; adjusted RD 0.016 (95% CI [-0.02, 0.05])). CONCLUSIONS: Our data demonstrate the safety of omitting AMP in patients undergoing TURP without pre-operative pyuria and a pre-operative, indwelling catheter. Source of Funding: / © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e355-e355 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Evert Baten More articles by this author Frank van der Aa More articles by this author Hans Goethuys More articles by this author Koen Slabbaert More articles by this author Ingrid Arijs More articles by this author Koen van Renterghem More articles by this author Expand All Advertisement Loading ...