Antibiotic prophylaxis for postoperative infective complications in patients undergoing TURP:systematic evaluation of the preventive effect / 中华泌尿外科杂志

ABSTRACT

Objective To determine whether antibiotic prophylaxis can reduce the risk of postoperative infective complications in patients undergoing TURP who have sterile preoperative urine. Methods MEDLINE,EMBASE,CBMA and the Cochrane Library were searched for RCTs comparing antibiotic prophylaxis with placebo/blank controls for patients undergoing TURP with preoperative sterile urine.The search strategy was made according to the Collaborative Review Group search strategy.Data were extracted by two reviewers using the designed extraction form. The software RevMan was used to review management and data analysis.The results were expressed as RR and 95% confidence intervals (CI) for categorical outcomes and weighted mean difference (WMD) and 95%CI for continuous outcomes. Results 53 relevant RCTs were searched, of which 27 were included and 26 were excluded.Antibiotic prophylaxis significantly decreased the rate of post-TURP bacteriuria,post-TURP fever,post-TURP bacteremia and the rate of continuous antibiotic use.The corresponding pooled relative risk (RR) and 95%CI was 0.36 (0.28 to 0.46),0.83 (0.71 to 0.97),0.43 (0.22 to 0.86) and 0.26 (0.20 to 0.33),respectively.However,the available data failed to prove that antibiotic prophylaxis shortened the duration of hospitalization (WMD, -0.31;95% CI , -0.78 to 0.35). Conclusions Prophylactic antibiotics can significantly decrease the incidence of post-TURP bacteriuria,fever,bacteremia and continuous antibiotic treatment,but cannot significantly shorten the duration of hospitalization.Antibiotics should be used in patients undergoing TURP.