Section of Female Pelvic Medicine and Reconstructive Surgery, Glickman Urological and Kidney Institute, The Cleveland Clinic, Cleveland, Ohio 44195, USA.
Urology. 2010 Jun;75(6):1305-8. doi: 10.1016/j.urology.2009.11.081. Epub 2010 Mar 17.
To review our postoperative infections using single-dose preoperative antibiotics. Midurethral synthetic sling surgery is commonly performed. Postoperative antibiotics are often prescribed and may have some risk of adverse events (AEs). We are unaware of data suggesting decreased risk of infection with this practice.
We reviewed all midurethral synthetic sling surgery charts from 2004 to 2008 performed by 1 surgeon who uses only single-dose preoperative antibiotics (controls), and 2 who also use postoperative antibiotics(cases). A telephone survey was administered, which included questions regarding postoperative infections and AEs related to antibiotic use. Our primary and secondary outcomes were urinary tract infections (UTIs) and AEs related to antibiotic use, respectively. Patients were excluded for bladder injuries, postoperative catheters, and concomitant prolapse surgery.
We identified 103 cases and 116 controls, and the telephone survey response rate was 81.3%. At baseline, groups had similar characteristics. There was no significant difference in UTIs between cases (6.8%) and controls (9.5%). There were no skin infections. AEs related to antibiotic use were more common among those that received postoperative antibiotics (7.8% vs 0.9%, P=.03). There were 5 (63%) yeast infections, 1 (12.5%) rash, 1 (12.5%) case of nausea, and 1 (12.5%) patient with colitis among cases and 1 yeast infection among controls.
UTI is common after sling surgery, but other infections are rare. The occurrence of UTI does not appear to be lower when postoperative antibiotics are prescribed. However, AEs associated with antibiotic use are increased. These findings do not support the use of postoperative antibiotics.
回顾我们使用单剂量术前抗生素的术后感染情况。中尿道合成吊带手术通常进行。术后常开具抗生素，可能存在一些不良事件（AE）的风险。我们不知道数据表明这种做法会降低感染风险。
我们回顾了 2004 年至 2008 年间由 1 名仅使用单剂量术前抗生素（对照组）的外科医生进行的所有中尿道合成吊带手术图表，以及 2 名也使用术后抗生素（病例组）的外科医生进行的所有中尿道合成吊带手术图表。进行了电话调查，其中包括术后感染和与抗生素使用相关的 AE 相关问题。我们的主要和次要结局分别是尿路感染（UTI）和与抗生素使用相关的 AE。对于膀胱损伤、术后导管和同时进行的脱垂手术的患者进行了排除。
我们确定了 103 例病例和 116 例对照，电话调查的回复率为 81.3%。在基线时，两组具有相似的特征。病例组（6.8%）和对照组（9.5%）之间 UTI 无显著差异。无皮肤感染。接受术后抗生素治疗的患者中，与抗生素使用相关的 AE 更为常见（7.8%比 0.9%，P=.03）。病例组有 5 例（63%）酵母感染、1 例（12.5%）皮疹、1 例（12.5%）恶心和 1 例（12.5%）结肠炎，对照组有 1 例酵母感染。
吊带手术后 UTI 很常见，但其他感染很少见。如果开具术后抗生素，UTI 的发生似乎不会降低。但是，与抗生素使用相关的 AE 增加。这些发现不支持使用术后抗生素。
