Antibiotic prophylaxis at the time of catheter removal after radical prostatectomy: A prospective randomized clinical trial

Berrondo, Claudia; Feng, Changyong; Kukreja, Janet Baack; Messing, Edward M.; Joseph, Jean

doi:10.1016/j.urolonc.2018.10.029

Cited by 13 publications

(17 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Assessing relevant UTI needs to be defined since not all patients with positive leucocyte esterase in the urinary deep stick analysis need to be treated or experience hazard. Further, using prophylactic antibiotic therapy with ciprofloxacin for instance, did not show to be effective in the prevention of UTI after RARP [21]. However, there is no increased risk for UTI with increased catheter indwelling time.…”

Section: Discussionmentioning

confidence: 96%

Ideal timing of indwelling catheter removal after robot-assisted radical prostatectomy with a running barbed suture technique: a prospective analysis of 425 consecutive patients

et al. 2019

View full text Add to dashboard Cite

Objective To compare prospectively early outcome and complications of catheter removal after robot-assisted radical prostatectomy (RARP) on the 4th or 7th day with a standardized running barbed suture technique. Introduction The time point of removing the indwelling catheter after RARP mainly depends on institute's/surgeon's preferences. Removal should be late enough to avoid urinary leakage and complications such as acute urinary retention (AUR) but early enough to avoid unnecessary catheter indwelling. Materials and methods A consecutive single-institutional series of patients underwent RARP between July 2015 and August 2017 and were entered in a prospectively maintained data base. Between July 2015 and December 2016 a cystogram was performed on 7th postoperative day (group A), thereafter the cystogram was performed on 4th postoperative day (group B). Incidence of acute urinary retention (AUR), urinary tract infections (UTI) and adverse events between the two cohorts was compared. Results 425 patients were analyzed (group A: n = 231; group B: n = 194). Both cohorts were comparable regarding demographic and oncological parameters. Watertight anastomosis was present in 84.8% in group A and in 82.5% in group B, respectively. AUR within 4 weeks after RARP occurred in 2.2% (n = 3) in A and 9.4% (n = 15) in B (p = 0.001). AUR within 72 h after catheter removal occurred in group A: 1% (n = 2) and in group B: 6.3% (n = 10) (p = 0.005). Symptomatic urinary tract infections occurred in 8.2% (n = 16) in group A and in 6.9% (n = 11) in group B. There were no differences in the rate of secondary anastomosis dehiscence. Age, BMI, prostate size, surgeon, or intraoperative bladder neck reconstruction were not correlated to the occurrence of AUR or UTI. Conclusions The removal of indwelling catheter on day 4 after a RARP with a running barbed suture shows similar anastomosis leakage rates as on the 7th postoperative day. However, AUR rates are higher for early removal. Patients scheduled for early removal should be carefully informed about the increased risk for AUR. Catheter indwelling time does not represent a risk factor for UTI.

show abstract

Section: Discussionmentioning

confidence: 96%

Ideal timing of indwelling catheter removal after robot-assisted radical prostatectomy with a running barbed suture technique: a prospective analysis of 425 consecutive patients

et al. 2019

View full text Add to dashboard Cite

show abstract

“…53 In a prospective randomized trial, antibiotic prophylaxis with ciprofloxacin at the time of catheter removal following prostatectomy was not associated with a reduction in CAUTI or Clostridium difficile infection. 54 However, in clinical practice, antibiotics are generally given at the time of catheter removal following radical prostatectomy, and a recent cross-sectional study showed that 60% of urologists routinely prescribed antibiotics prior to catheter removal. 55 In a clinically integrated, cluster, randomized trial, patients were allocated to 1-or 3-day course of ciprofloxacin at the time of catheter removal.…”

Section: Antibiotic Prophylaxismentioning

confidence: 99%

Catheter-Associated Urinary Tract Infections: Current Challenges and Future Prospects

Werneburg¹

2022

RRU

View full text Add to dashboard Cite

Catheter-associated urinary tract infection (CAUTI) is the most common healthcare-associated infection and cause of secondary bloodstream infections. Despite many advances in diagnosis, prevention and treatment, CAUTI remains a severe healthcare burden, and antibiotic resistance rates are alarmingly high. In this review, current CAUTI management paradigms and challenges are discussed, followed by future prospects as they relate to the diagnosis, prevention, and treatment. Clinical and translational evidence will be evaluated, as will key basic science studies that underlie preventive and therapeutic approaches. Novel diagnostic strategies and treatment decision aids under development will decrease the time to diagnosis and improve antibiotic accuracy and stewardship. These include several classes of biomarkers often coupled with artificial intelligence algorithms, cell-free DNA, and others. New preventive strategies including catheter coatings and materials, vaccination, and bacterial interference are being developed and investigated. The antibiotic pipeline remains insufficient, and new strategies for the identification of new classes of antibiotics, and rational design of small molecule inhibitor alternatives, are under development for CAUTI treatment.

show abstract

“…In one trial, conducted by Niël-Weise et al, in comparing antibiotic prophylaxis with antibiotics administration when clinically indicated in the female surgical patients who had a urethral catheter for more than 24 hours, symptomatic UTI was less frequent in the prophylaxis group (RR 0.20, 95% CI 0.06 to 0.66) [ 52 ]. Likewise, Berrondo et al, in their prospective, randomized, controlled trial, using antibiotic prophylaxis with oral ciprofloxacin before urinary catheter removal after radical prostatectomy did not decrease UTI rate [ 49 ].…”

Section: Reviewmentioning

confidence: 99%

Catheter-Associated Urinary Tract Infections in the Adult Patient Group: A Qualitative Systematic Review on the Adopted Preventative and Interventional Protocols From the Literature

Gad¹,

AbdelAziz²

2021

Cureus

View full text Add to dashboard Cite

Catheter-associated urinary tract infections (CA-UTIs) are among the most common nosocomial infections acquired by patients in health care settings. A significant risk factor for CA-UTIs is the duration of catheterization. To summarize the current strategies and interventions in reducing urinary tract infections associated with urinary catheters, use and the need for re-catheterization on the rate of CA-UTIs, we performed a systematic review. A rapid evidence analysis was carried out in the Medline (via Ovid) and the Cochrane Library for the periods of January 2005 till April 2021. The main inclusion criterion required to be included in this review was symptomatic CA-UTI in adults as a primary or secondary outcome in all the included studies. Only randomized trials and systematic reviews were included, reviewed, evaluated, and abstracted data from the 1145 articles that met the inclusion criteria. A total of 1145 articles were identified, of which 59 studies that met the inclusion criteria were selected. Studies of relevance to CA-UTIs were based on: duration of catheterization, indication for catheterization, catheter types, UTI prophylaxis, educational proposals and approaches, and mixed policies and interventions. The duration of catheterization is the contributing risk factor for CA-UTI incidence; longer-term catheterization should only be undertaken where needed indications. The indications for catheterization should be based on individual base to base cases. The evidence for systemic prophylaxis instead of when clinically indicated is still equivocal. However, antibioticimpregnated catheters reduce the risk of symptomatic CA-UTIs and bacteriuria and are more cost-effective than other impregnated catheter types. Antibiotic resistance, potential side effects and increased healthcare costs are potential disadvantages of implementing antibiotic prophylaxis.Multiple interventions and measures such as reducing the number of catheters in place, removing catheters at their earliest, clinically appropriate time, reducing the number of unnecessary catheters inserted, decrease antibiotic administration unless clinically needed, raising more awareness and provide training of nursing personnel on the latest guidelines, can effectively lower the incidence of CA-UTIs.

show abstract

Antibiotic prophylaxis at the time of catheter removal after radical prostatectomy: A prospective randomized clinical trial

Cited by 13 publications

References 19 publications

Ideal timing of indwelling catheter removal after robot-assisted radical prostatectomy with a running barbed suture technique: a prospective analysis of 425 consecutive patients

Ideal timing of indwelling catheter removal after robot-assisted radical prostatectomy with a running barbed suture technique: a prospective analysis of 425 consecutive patients

Catheter-Associated Urinary Tract Infections: Current Challenges and Future Prospects

Catheter-Associated Urinary Tract Infections in the Adult Patient Group: A Qualitative Systematic Review on the Adopted Preventative and Interventional Protocols From the Literature

Contact Info

Product

Resources

About