The necessity of treating asymptomatic bacteriuria with antibiotics in the perioperative period of joint arthroplasty: a metaanalysis

Abstract

Background Oral antibiotics are used to treat asymptomatic bacteriuria during the perioperative period of joint replacement usually. However, there is no unified conclusion on whether or not asymptomatic bacteriuria causes infection around joint prostheses, and the efficacy of antibiotics is unknown. Methods We systematically searched PubMed, CNKI, Ovid, Cochrane Library, EMBASE, manual research, and references of relevant articles up to January 1, 2020, to identify observational studies comparing. The Cochrane systematic review method was used, and the review Manager 5.3 software was used for analysis. Result (1) Nine articles were enrolled, involving 29844 cases of joint arthroplasty, including 2366 cases of asymptomatic bacteriuria. (2) The periprosthetic joint infection had a significantly higher incidence in the asymptomatic bacteriuria group than that in the non-asymptomatic bacteriuria group (Odd Ratio: OR=3.15, 95%CI: 1.23-8.02, P=0.02). (3) Seven in the nine articles reported the use of antibiotics for treating perioperative asymptomatic bacteriuria, and there was no significant difference in the incidence of Periprosthetic joint infection between two groups (OR=1.64, 95%CI: 0.84-3.23, P=0.15). Conclusion The occurrence of asymptomatic bacteriuria in the perioperative period of joint arthroplasty is a risk factor for periprosthetic joint infection, and the use of antibiotics for asymptomatic bacteriuria does not change the incidence.

Urinary infection: Modern approach to diagnosis and treatment

“…Iako je primećeno češće javljanje infekcija operativnog mesta kod ortopedskih pacijenata koji su imali asimptomatsku bakteriuriju koja nije lečena antibioticima pre operativnog lečenja, metaanaliza brojnih studija nije za sada dala jasnu preporuku za preoperativni tretman antibioticima ovih pacijenata 5 . Metaanaliza studija kojima su analizirani rizici za pojavu infekcije i drugih komplikacija nakon kardiohirurških operacija učinjenih kod pacijenata sa preoperativnom asimptomatskom bakteriurijom je takođe pokazala da upotreba antibiotika ni u ovim slučajevima nije opravdana 6 .…”