Urogenit Tract Infect.  2016 Dec;11(3):77-85. 10.14777/uti.2016.11.3.77.

Antimicrobial Prophylaxis in Urological Surgery

• Yamamoto S
• Shigemura
• Kiyota H
• Arakawa S
• Japanese Research Group for UTI

• KMID: 2366142
• DOI: http://doi.org/10.14777/uti.2016.11.3.77

Abstract

Surgical site infection (SSI) is defined as an infection occurring within one month from surgery or intervention. SSIs are classified into three categories: Clean, clean-contaminated, and contaminated. They are defined as procedures that avoid entering the urinary tract, involve entry of the urinary tract, and involve the bowels, respectively. The purpose of antimicrobial prophylaxis (AMP) is to protect the surgical wound from contamination by normal bacterial flora. AMP should be based on penicillin with beta-lactamase inhibitors, or first- or second-generation cephalosporins. Broad-spectrum antimicrobials, such as third- and fourth-generation cephalosporins or carbapenems, should be used to treat postoperative infections but not AMP. AMP should be started no less than 30 minutes prior to the start of the operation. AMP should be administered by a single dose or be terminated within 24 hours in cases of transurethral, clean, or clean-contaminated surgery, and within 2 days in cases of bowl (contaminated) surgery. These guidelines are applicable preoperatively only for non-infected, low-risk patients. The risk of patients for infection should be evaluated preoperatively, such as with a urine culture test. In cases with preoperative infection or bacteriuria that can cause an SSI or urinary tract infection following surgery, patients must receive adequate preoperative treatment based on their individual situation.

Keyword

Surgical wound infection; Antimicrobial prophylaxis; Urological surgery

MeSH Terms

Bacteriuria
beta-Lactamase Inhibitors
Carbapenems
Cephalosporins
Humans
Penicillins
Surgical Wound Infection
Urinary Tract
Urinary Tract Infections
Wounds and Injuries
Carbapenems
Cephalosporins
Penicillins
beta-Lactamase Inhibitors

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