尿道下裂成形术置入支架是否需预防性使用抗生素？
作者：Niki Kanaroglou, Elias Wehbi, Abdulhakim Alotay, Darius J. Bagli, et al. 来源：Journal of Urology 日期：2013-02-19
导读
Is There A Role For Prophylactic Antibiotics After Stented Hypospadias Repair?
Abstract
Introduction
Data on prophylactic oral antibiotics (POA) use in stented hypospadias repair is lacking. Herein we evaluate the role of POA in preventing symptomatic urinary tract infections (UTI) in this population.
Materials and Methods
We reviewed consecutive patients (September 2009 – January 2012) undergoing stented primary/redo hypospadias repair by a single surgeon. All patients received antibiotics on induction. Prior to April 1, 2011 patients also received POA while stented. They were compared to those undergoing surgery after April 1, who received no POA. The primary outcome was symptomatic UTI, captured from patient records, and verified by an electronic crosscheck of ICD-10 codes. Secondary outcomes included cellulitis, fistula, dehiscence and meatal stenosis.
Results
161 patients were reviewed, where 11 were unstented and 1 had follow up elsewhere. Of the remaining 149 patients, 78 received POA and 71 did not. The groups were well matched for age, hypospadias characteristics, surgical technique, and stenting duration. Median follow up was 17 months(0.2-33).
No culture proven symptomatic UTIs occurred in either group. One patient in the POA group was treated for cellulitis by the pediatrician. The complication rates, including redo cases, were 18.2% in the POA group and 15.3% in the non-POA group (p=0.8).
Conclusion
When postoperative POA were not administered, we identified no increased incidence of symptomatic UTIs or complications. Our data suggests that POA may not be necessary in stented hypospadias repair. This study contributes to the growing body of evidence supporting the rational use of antimicrobials, and can potentially serve as a basis for a prospective multicenter randomized study.
http://www.jurology.com/article/S0022-5347(13)00284-X/abstract
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