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The following is a summary of “Long-term perioperative antibiotic prophylaxis after urethral reconstruction does not improve clinical outcomes and increases incidence of MDR organisms,” published in the November 2024 issue of Urology by Hoover et al.
Researchers conducted a retrospective study to assess the effect of long-term postoperative antibiotics after urethral reconstruction.
They reviewed patients undergoing urethral reconstruction by a single surgeon from 2019 to 2023. Patients received either 3–4 weeks of prophylactic antibiotics with indwelling catheters or no antibiotics. Preoperative and postoperative urine cultures were collected from all patients. The primary outcome was the association of prophylactic antibiotics with multidrug-resistant (MDR) bacteria in postoperative urine cultures, and secondary outcomes included perioperative differences.
The results showed a significant difference in MDR organisms between patients who received antibiotic prophylaxis (84) and those who did not (63) (P <.01). However, there were no significant differences in perioperative outcomes, including positive urine cultures, clinical urinary tract infections (UTIs), wound complications, or recurrence.
They concluded that postoperative antibiotic prophylaxis did not affect perioperative outcomes but increased the risk of MDR bacteria. This finding suggested that routine use of prophylactic antibiotics in urethral reconstruction should be discouraged.
Source: link.springer.com/article/10.1007/s00345-024-05358-7
