Single versus multi-dose antibiotic prophylaxis for pelvic organ prolapse surgery with graft/mesh.

OBJECTIVE

To compare the risk of postoperative infections in women who receive single-dose versus multi-dose prophylactic antibiotic regimen during prolapse surgery with mesh/graft.

STUDY DESIGN

Retrospective cohort study of 460 women who underwent prolapse surgery with mesh/graft. We compared women who received a single-dose prophylactic antibiotic regimen to those who received a multi-dose regimen. The primary outcome was the presence of any postoperative infection, defined as the presence of any of the following infections: urinary tract infection (UTI), fever, wound or trocar site infection, mesh infection or pelvic abscess. Associations between prophylactic antibiotic regimen and postoperative infections were estimated using univariable and multivariable analysis.

RESULTS

Rate of any postoperative infection was similar between the single- and multi-dose groups (19% vs. 16%, p=0.50). Rate of UTI was significantly higher in the single-dose compared to the multi-dose group (13% vs. 7%, p=0.03). On multivariable analysis, after controlling for vaginal route of surgery, the odds of UTI was not significantly different between groups (OR 0.59, 95% CI 0.27, 1.26).

CONCLUSION

A single-dose antibiotic regimen is sufficient for prophylaxis against postoperative infections in women undergoing prolapse surgery with graft/mesh.