Comparison of single‐ and multiple‐dose cefazolin as prophylaxis for transurethral enucleation of prostate: A multicenter, prospective, randomized controlled trial by the Japanese Research Group for Urinary Tract Infection

Abstract

Objectives To compare the optimal administration period of antimicrobial prophylaxis in patients undergoing transurethral enucleation of the prostate for benign prostatic hyperplasia. Methods We carried out a randomized controlled trial to compare the differences in incidence of perioperative genitourinary tract infection between single and multiple (3 days) administrations of cefazolin for transurethral enucleation of the prostate in benign prostatic hyperplasia patients without pyuria or bacteriuria between January 2015 and December 2018. Results This multicenter randomized controlled trial included 203 patients who underwent a transurethral enucleation of the prostate procedure. All received antimicrobial prophylaxis, and were randomized into those who received single‐dose (n = 101) or multiple‐dose (n = 102) therapy. The rate of genitourinary tract infection after transurethral enucleation of the prostate for all patients was 1.5%, whereas that in the single‐dose group was 1.0% and in the multiple‐dose group was 2.0%, which were not significantly different (P = 1.00). Conclusions A single dose of antimicrobial prophylaxis as a prophylactic antibacterial drug is sufficient for patients undergoing transurethral enucleation of the prostate who do not have presurgical pyuria or bacteriuria.

Complicated urinary tract infection in patients with benign prostatic hyperplasia

“…Short-course antibiotic protocols (more than 1 antibiotic dose administered within 72 h of surgery) can be more effective than single-dose regimens [30]. However, recent multicenter randomized controlled trial showed no significant difference between single-and multiple-dose cefazolin as prophylaxis for transurethral enucleation of prostate [34]. In the absence of an indwelling catheter, antimicrobial therapy likely can be discontinued after the procedure [32,33,35].…”

Editorial Comment to Comparison of single‐ and multiple‐dose cefazolin as prophylaxis for transurethral enucleation of prostate: A multicenter, prospective, randomized controlled trial by the Japanese Research Group for Urinary Tract Infection

“…The article by Togo et al sought to compare the optimal administration periods of cefazolin, antimicrobial prophylaxis, in patients undergoing transurethral enucleation of the prostate for benign prostatic hyperplasia. 1 No previous study has carried out the optimal regimens of prophylactic antibiotics for transurethral enucleation of the prostate. Therefore, this article is significant, although a relatively small number of cases were registered.…”