Antibiotic Prophylaxis Decreases Surgical Site Infections after Radical Prostatectomy

Chatenet M1 , Vincendeaua S1 , Bataillon-Buf S2 , Peyronneta B1 , Verhoesta G1 , Manuntaa A1 , Guille F1 , Shariat SF3,4,5,6, Bensala K1 , Mathieu R1*

Department of Urology, Rennes University Hospital, France 2 Unit? d'Hygi?ne Hospitali?re, P?le Microorganismes, CHU Pontchaillou, Rennes, France 3 Department of Urology, Medical University Vienna, General Hospital, Vienna, Austria 4 Department of Urology, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA 5 Department of Urology, Weill Cornell Medical College, New York, USA 6 Karl Landsteiner Institute, Vienna, Austria

^*Correspondance to: Romain Mathieu 

 PDF  Full Text DOI: 10.25107/2474-1647.3055

Abstract

Background: Routine use of Antibiotic Prophylaxis (AP) in Radical Prostatectomy (RP) is still questionable since no comparative placebo-controlled study has been conducted. The aim of the study was to describe Surgical Site Infections (SSI), identify predictive factors of SSI, and determine the role of AP in a large cohort of patients treated with RP. Methods: Laparoscopic or robot assisted RP was performed in 295 consecutive patients between January 2010 to December 2013 in a single academic institution. Patients and operative characteristics, post-operative complications and SSI were retrospectively collected. From July 2012, patients received systematic AP during the procedure. Qualitative and quantitative variables were compared by using chi2 and Student t tests. Relationships between SSI and patient or treatment parameters including use of AP were determined using univariable and multivariable regression logistic analyses. Results: 292 patients were analyzed. Median age was 62 years. 107 patients (36.6%) received AP. SSI occurred in 52 patients (17.8%). SSI were superficial incisional SSI (n=28), and organ/space SSI (n=26). No deep incisional SSI was reported. In univariable analysis, SSI was associated with a preoperative immunosuppressive therapy (HR=7.286; CI 95% = 1.185-44.761; p=0.035), post-operative complications (HR=2.545; CI 95% = 1.027-6.312; p=0.044), and use of AP (HR=0.458; CI 95% = 0.223-0.918; p=0.028). In multivariable analysis, only post-operative complications (HR=2.603; CI 95% = 1.014-6.680; p=0.047), and use of AP (HR=0.410; CI 95% = 0.198-0.847; p=0.016) remained independent predictors. Conclusion: Use of AP in RP is associated with a decrease of SSI. The impact of AP on SSI incidence should be confirmed in a comparative, prospective, controlled study

Keywords

Surgical wound infection; Antibiotic prophylaxis; Predictive factors; Radical prostatectomy; Prostate cancer

Cite the article

Chatenet M, Vincendeaua S, BataillonBuf S, Peyronneta B, Verhoesta G, Manuntaa A, et al. Antibiotic Prophylaxis Decreases Surgical Site Infections after Radical Prostatectomy. Clin Surg. 2021; 6: 3055..