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Efficacy of 1 versus 3 days of intravenous amikacin as a prophylaxis for patients undergoing transurethral resection of the prostate: A prospective randomized trial

INTRODUCTION: There are no uniform guidelines on the duration of antibiotic prophylaxis for transurethral resection of the prostate (TURP). The objective of this study was to evaluate the efficacy of 1 day versus 3 days of intravenous amikacin as prophylaxis, before TURP. MATERIALS AND METHODS: In t...

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Autores principales: Jayanth, Selvin Theodore, Chandrasingh, J., Sahni, Rani Diana, Mukha, Rajiv Paul, Kumar, Santosh, Devasia, Antony, Kekre, Nitin Sudhakar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8173930/
https://www.ncbi.nlm.nih.gov/pubmed/34103795
http://dx.doi.org/10.4103/iju.IJU_494_20
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author Jayanth, Selvin Theodore
Chandrasingh, J.
Sahni, Rani Diana
Mukha, Rajiv Paul
Kumar, Santosh
Devasia, Antony
Kekre, Nitin Sudhakar
author_facet Jayanth, Selvin Theodore
Chandrasingh, J.
Sahni, Rani Diana
Mukha, Rajiv Paul
Kumar, Santosh
Devasia, Antony
Kekre, Nitin Sudhakar
author_sort Jayanth, Selvin Theodore
collection PubMed
description INTRODUCTION: There are no uniform guidelines on the duration of antibiotic prophylaxis for transurethral resection of the prostate (TURP). The objective of this study was to evaluate the efficacy of 1 day versus 3 days of intravenous amikacin as prophylaxis, before TURP. MATERIALS AND METHODS: In this prospective randomized control trial, patients with sterile preoperative urine culture were randomized to receive either 1 day (Group A) or 3 days (Group B) of intravenous (IV) amikacin. All patients had their catheter removed on the 3(rd) day and a midstream urine culture was obtained on the 4(th) day. The follow-up was scheduled at 1 week and at 1 month. The rate of bacteriuria on the 4(th) postoperative day was analyzed as the primary outcome. The secondary outcomes included symptomatic urinary tract infection (UTI), its risk factors, and other complications at 1 month. RESULTS: Of the 338 patients randomized, 314 patients were evaluable until day 7 and 307 until 1 month. Bacteriuria rate at day 4 (Group A: 8.8% [95% confidence interval (CI): 4.2–13.2]; Group B: 4.4% [95% CI: 1.2%–7.7%], P = 0.124, Fisher's exact test) was similar in both the groups. At 1 month, the rate of symptomatic UTI was also similar in both the groups (3.5% [95% CI: 0.8–6.9] vs. 1.7% [95% CI: 0.2–4.2], P = 0.344, Fisher's exact test). Bacteriuria (colony-forming unit, >10(4)/ml) at day 4 was a significant risk factor for developing symptomatic UTI (P = 0.006). Antibiotic resistance was higher in Group B (P = 0.002) (Group A: 7.1% [95% CI: 6.3–20] vs. Group B: [71%, CI: 38–104], P = 0.0021, Fisher's exact test). CONCLUSION: One day is possibly noninferior to 3 days of IV amikacin as prophylaxis in patients undergoing TURP with respect to bacteriuria and symptomatic UTI, with an added advantage of lower antibiotic resistance.
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spelling pubmed-81739302021-06-07 Efficacy of 1 versus 3 days of intravenous amikacin as a prophylaxis for patients undergoing transurethral resection of the prostate: A prospective randomized trial Jayanth, Selvin Theodore Chandrasingh, J. Sahni, Rani Diana Mukha, Rajiv Paul Kumar, Santosh Devasia, Antony Kekre, Nitin Sudhakar Indian J Urol Original Article INTRODUCTION: There are no uniform guidelines on the duration of antibiotic prophylaxis for transurethral resection of the prostate (TURP). The objective of this study was to evaluate the efficacy of 1 day versus 3 days of intravenous amikacin as prophylaxis, before TURP. MATERIALS AND METHODS: In this prospective randomized control trial, patients with sterile preoperative urine culture were randomized to receive either 1 day (Group A) or 3 days (Group B) of intravenous (IV) amikacin. All patients had their catheter removed on the 3(rd) day and a midstream urine culture was obtained on the 4(th) day. The follow-up was scheduled at 1 week and at 1 month. The rate of bacteriuria on the 4(th) postoperative day was analyzed as the primary outcome. The secondary outcomes included symptomatic urinary tract infection (UTI), its risk factors, and other complications at 1 month. RESULTS: Of the 338 patients randomized, 314 patients were evaluable until day 7 and 307 until 1 month. Bacteriuria rate at day 4 (Group A: 8.8% [95% confidence interval (CI): 4.2–13.2]; Group B: 4.4% [95% CI: 1.2%–7.7%], P = 0.124, Fisher's exact test) was similar in both the groups. At 1 month, the rate of symptomatic UTI was also similar in both the groups (3.5% [95% CI: 0.8–6.9] vs. 1.7% [95% CI: 0.2–4.2], P = 0.344, Fisher's exact test). Bacteriuria (colony-forming unit, >10(4)/ml) at day 4 was a significant risk factor for developing symptomatic UTI (P = 0.006). Antibiotic resistance was higher in Group B (P = 0.002) (Group A: 7.1% [95% CI: 6.3–20] vs. Group B: [71%, CI: 38–104], P = 0.0021, Fisher's exact test). CONCLUSION: One day is possibly noninferior to 3 days of IV amikacin as prophylaxis in patients undergoing TURP with respect to bacteriuria and symptomatic UTI, with an added advantage of lower antibiotic resistance. Wolters Kluwer - Medknow 2021 2021-04-01 /pmc/articles/PMC8173930/ /pubmed/34103795 http://dx.doi.org/10.4103/iju.IJU_494_20 Text en Copyright: © 2021 Indian Journal of Urology https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Jayanth, Selvin Theodore
Chandrasingh, J.
Sahni, Rani Diana
Mukha, Rajiv Paul
Kumar, Santosh
Devasia, Antony
Kekre, Nitin Sudhakar
Efficacy of 1 versus 3 days of intravenous amikacin as a prophylaxis for patients undergoing transurethral resection of the prostate: A prospective randomized trial
title Efficacy of 1 versus 3 days of intravenous amikacin as a prophylaxis for patients undergoing transurethral resection of the prostate: A prospective randomized trial
title_full Efficacy of 1 versus 3 days of intravenous amikacin as a prophylaxis for patients undergoing transurethral resection of the prostate: A prospective randomized trial
title_fullStr Efficacy of 1 versus 3 days of intravenous amikacin as a prophylaxis for patients undergoing transurethral resection of the prostate: A prospective randomized trial
title_full_unstemmed Efficacy of 1 versus 3 days of intravenous amikacin as a prophylaxis for patients undergoing transurethral resection of the prostate: A prospective randomized trial
title_short Efficacy of 1 versus 3 days of intravenous amikacin as a prophylaxis for patients undergoing transurethral resection of the prostate: A prospective randomized trial
title_sort efficacy of 1 versus 3 days of intravenous amikacin as a prophylaxis for patients undergoing transurethral resection of the prostate: a prospective randomized trial
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8173930/
https://www.ncbi.nlm.nih.gov/pubmed/34103795
http://dx.doi.org/10.4103/iju.IJU_494_20
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