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Ann Surg. 2009 Apr;249(4):573-5. doi: 10.1097/SLA.0b013e31819a0315.

Antibiotic prophylaxis at urinary catheter removal prevents urinary tract infections: a prospective randomized trial.

Author information

1
Department of Surgery, St. Claraspital, Basel, Switzerland. urs.pfefferkorn@gmail.com

Abstract

OBJECTIVE:

To assess whether antibiotic prophylaxis at urinary catheter removal reduces the rate of urinary tract infections.

SUMMARY OF BACKGROUND DATA:

Urinary tract infections are among the most common nosocomial infections. Antibiotic prophylaxis at urinary catheter removal is used as a measure to prevent them, albeit without supporting evidence.

METHODS:

A prospective randomized study enrolled 239 patients undergoing elective abdominal surgery, who were randomized either for receiving 3 doses of trimethoprim-sulfamethoxazole at urinary catheter removal, or not. Urinary tract infections were diagnosed according to Center of Disease Control definitions. Urinary cultures were obtained before and 3 days after catheter removal. Subjective symptoms were assessed by an independent study-blind urologist.

RESULTS:

Patients who received antibiotic prophylaxis showed significantly fewer urinary tract infections (5/103, 4.9%) than those without prophylaxis (22/102, 21.6%), P < 0.001. The absolute risk reduction for the occurrence of a urinary tract infection was 16.7%; the relative risk reduction was 77.5%, and the number needed to treat was 6. Patients with antibiotic prophylaxis also had less significant bacteriuria 3 days after catheter removal (17/103, 16.5%) than those without (42/102, 41.2%), P < 0.001.

CONCLUSIONS:

Antibiotic prophylaxis with trimethoprim-sulfamethoxazole on urinary catheter removal significantly reduces the rate of symptomatic urinary tract infections and bacteriuria in patients undergoing abdominal surgery with perioperative transurethral urinary catheters.

PMID:
19300235
DOI:
10.1097/SLA.0b013e31819a0315
[Indexed for MEDLINE]

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