Post-operative infection and prophylactic antibiotic administration after radical cystectomy with orthotopic neobladderurinary diversion

摘要

The purpose of this study was to investigate the association between prophylactic antibiotic administration (PAA) andpost-operative infection in radical cystectomy with orthotopic neobladder urinary diversion carried out for patients withbladder cancer. Fifty-seven consecutive cases were analyzed retrospectively. Post-operative infections were categorized asurinary tract, wound, and remote infections. We used the antibiotics tazobactam/piperacillin (TAZ/PIPC), sulbactam/ampicillin(SBT/ABPC), flomoxef (FMOX), cefazolin (CEZ), cefotiam (CTM), and cefmetazole (CMZ). Twenty-five (43.9%) patients hadpost-operative infections. Five of these (8.77%) patients had wound infections, 22 (38.6%) patients had urinary tractinfections, and 2 (3.51%) had remote infections. Our statistical analysis demonstrated that the patients with TAZ/PIPC usedfor PAA (5/18: 27.8%) had a significantly lower post-operative infection rate than patients with other antibiotics (24/39:61.5%) (p = 0.0442). In addition, the patients with a shorter-duration PAA (within 72 h after the operation (48-72 h)) had asignificantly lower rate of post-operative infections (12/33: 36.4%) than those with longer-duration PAA (longer than 72-96 hafter the operation) (16/24: 66.7%) (p = 0.0239). Taken together, these results suggest that TAZ/PIPC with shorter PAAduration (within 72 h) might lead to a lower rate of post-operative infections. In conclusion, our data showed that PAA withTAZ/PIPC with a shorter duration PAA (within 72 h) might be recommended for radical cystectomy with orthotopic neobladderreconstruction. A prospective study based on our data is desirable to establish or revise guidelines for prophylacticmedication for preventing post-operative infection after radical cystectomy with orthotopic neobladder urinary diversion.