Prophylactic Antimicrobial Therapy and Antimicrobial Stewardship in Urologic Surgery

Abstract

Postoperative infectious complications are a worrying problem for surgeons. Urological surgery has a higher risk of postoperative urinary tract infection than other surgeries because of the common use of various types of catheters. Due to the recent increase in antibiotic resistance, antimicrobial stewardship recommends using appropriate antibiotics for a suitable period. It is generally advocated that prescribing antibiotics in the absence of infection is equivalent to the inappropriate use of antibiotics. Based on numerous studies reported by several academic societies, appropriate use of antibiotics before surgery has been suggested. It was confirmed that using antibiotics according to these guidelines reduces the use of antibiotics without increasing the incidence of postoperative infectious complications. Furthermore, endourological surgery reports have proved the efficacy of antibiotics given once before surgery. Differences in antibiotic resistance by region must be taken into consideration when selecting the appropriate antibiotic type.

Perioperative Antibiotic Prophylaxis in Urological Surgery: An Update Systematic Review

“…SSIs are defined by the CDC as an infection that occurs within 30 days post-surgery, which can be categorized into three levels of severity, that are superficial incisional, deep incisional, and organ or space infection. [21][22][23][24] The standard of treatment for preventing surgical site infections is antibiotic prophylaxis (AP) before surgery. 2 Class I surgery may not require single-dose antibiotic prophylaxis.…”