Are prophylactic antibiotics really necessary in donor nephrectomy patients?

ABSTRACT

OBJECTIVE: To determine whether prophylactic antibiotics are necessary in preventing possible postoperative infectious complications in healthy living kidney donorsMATERIALS AND METHODS: Twenty-five living kidney donors were divided into two groups Group A - received intravenous normal saline solution (placebo) and Group B - received prophylactic broad-spectrum antibiotics. Both of these were administered one hour prior to donor nephrectomy and in two doses within 24 hours postoperatively. Signs of postoperative infection were evaluated with fever, pyuria, wound changes and bacteriologic studies as clinical parameters. Data were analyzed using the chi-square testRESULTS: Five patients (30.7 percent) in the placebo group and two patients (16 percent) in the prophylaxis group developed postoperative fever. The differences in these two groups were however not statistically significant. "Significant pyuria" was noted in two patients belonging to group A while none was seen in group B. The presence of urinary tract infection was documented in both cases by culture studies. No patient in Group B developed urinary tract infection. This difference however, was not statistically significant. No documented wound infection occurred in both placebo and prophylaxis groups. However, one patient in the placebo group developed serous wound discharge, which healed with intake of antibiotics, and daily wound careCONCLUSIONS: No statistically significant differences were observed in donor nephrectomies who received either placebo or broad-spectrum prophylaxis in terms of postoperative fever, significant pyuria and wound infection. The use of prophylactic antibiotics in these otherwise healthy individuals may not really be necessary in preventing postoperative infectious complications. (Author)