What is the efficacy of preoperative prophylaxis for male patients with urinary tract infection (UTI)?

Updated: Aug 27, 2019
  • Author: John L Brusch, MD, FACP; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Preoperative antibiotics can reduce complications. Procedures of concern include open, transurethral, or laser prostatectomy; transrectal prostate biopsy; cystoscopy in patients with preoperative bacteruria or a preoperative indwelling catheter; and renal transplantation. Before antibiotic coverage, the rate of septicemia from a transrectal biopsy was 5-10%; currently, the rate is less than 0.1%. Fluoroquinolones are the prophylactic drugs of choice for urologic procedures.

Post-transurethral prostatectomy (TURP) bacteriuria rates are approximately 10% in patients who receive systemic antibiotics, compared with approximately 35% in those who do not. Single-dose therapy is as effective as longer treatment courses.

Unfortunately, neither cefuroxime nor ciprofloxacin has been shown to reduce the rate of bacteriuria (approximately 20%) after lithotripsy.


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