Comparison of Perioperative Prophylactic Antibiotic Protocols in Preventing the Infectious Complications after Open Prostatectomy

摘要

Urologic surgeries can cause various infectious complications. Surgical site infections (SSIs) and postoperative urinary tract infections (UTIs) are common complications and a major source of post operative morbidity. Surgical site infections complicate up to 5% of clean extra-abdominal operations and up to 20% of intra-abdominal procedures". Incidence of these complications depends on potential patient's risk factors, environment and type of surgical technique. Since the patients have different risk factors for complications, careful evaluation is necessary. Perioperative administration of antibiotics is one of several measures which intend to reduce post-procedural local and systemic infectious complications. Despite lots of researches, antibiotic prophylaxis in urologic surgeries remains controversial. The principles about antibiotics such as type, timing and duration of administration, route and dosage have been debated. Remarkable notes on long-term course of antibiotics are antimicrobial resistance, side-effects of long-term antibiotic treatment and the burden of high unnecessary costs for patients and healthcare system. Cephalosporins are generally efficacious for procedures. They can enter the urinary tract, have a long half-life, and are inexpensive and rarely associated with allergic reactions. For most operations, prophylaxis should be started 30 to 120 minutes before incision and discontinued within 24 hours post operation".