Comparison of three different antibiotic protocols in transurethral resection of bladder tumour and the possible infectious risk factors: A non-randomized, prospective study

  • Jorge Panach-Navarrete Department of Urology. University Clinic Hospital of Valencia. Facultat de Medicina i Odontologia. Universitat de València.
  • Lorena Valls-González Department of Urology. University Clinic Hospital of Valencia. Facultat de Medicina i Odontologia. Universitat de València.
  • Eduardo Sánchez-Cano Department of Urology. University Clinic Hospital of Valencia. Facultat de Medicina i Odontologia. Universitat de València.
  • María Medina-González Department of Urology. University Clinic Hospital of Valencia. Facultat de Medicina i Odontologia. Universitat de València.
  • Ana Castelló-Porcar Department of Urology. University Clinic Hospital of Valencia. Facultat de Medicina i Odontologia. Universitat de València.
  • Jose María Martínez-Jabaloyas Department of Urology. University Clinic Hospital of Valencia. Facultat de Medicina i Odontologia. Universitat de València.

Abstract

Introduction: We sought to investigate three different antibiotic protocols in transurethral resection of a bladder tumour (TURBT), and the possible infectious risk factors of this surgery.

Methods: We conducted a non-randomized, prospective study, gathering cases of patients in whom TURBT had been performed. The sample was divided into three groups based on those who received antibiotics as: a single preoperative dose (Group A); a preoperative dose, plus a long protocol during the hospitalization (Group B); a preoperative dose, plus a long protocol during the hospitalization, plus five days at home (Group C). Intra- and postoperative data that could be relevant to infections was gathered.

Results: A total of 219 patients were included. In the multivariate analysis, it was observed that the patients in Group A were more prone to re-hospitalization due to fever than were those from Group C (odds ratio [OR] 11.13; p=0.03). Furthermore, the cases with tumour necrosis and those who entered surgery with a urinary catheter were more prone to have a temperature above 37.5ºC (OR6.74; p=0.02 and OR6.4; p=0.04, respectively), as well as have an increased risk per every additional tumour in the cystoscopy (OR 1.32; p=0.01). Those who received mitomycin had a lower chance of a positive urine culture (OR 0.29; p=0.01), contrary to those patients with over two days of hospitalization (OR 4.11; p<0.01) and those who entered surgery with a urinary catheter (OR 12.35; p=0.02).

Conclusions: Those patients that only received a single dose of antibiotic before TURBT may have an increased risk of re-hospitalization due to fever in comparison to those who received prolonged antibiotic protocols. In addition, there are perioperative factors in this surgery that predict the risk of infectious complications.

Published
2018-06-07
How to Cite
Panach-Navarrete, J., Valls-González, L., Sánchez-Cano, E., Medina-González, M., Castelló-Porcar, A., & Martínez-Jabaloyas, J. M. (2018). Comparison of three different antibiotic protocols in transurethral resection of bladder tumour and the possible infectious risk factors: A non-randomized, prospective study. Canadian Urological Association Journal, 12(11). https://doi.org/10.5489/cuaj.5207
Section
Original Research