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Objectives

Antibiotics are shown to reduce the risk of infectious complications. However, the duration of the antibiotic course for catheterized patients undergoing transurethral resection of prostate (TURP) is still controversial. This study aimed to compare effectiveness of a short-term antibiotic course versus an established long-term course in preventing post-operative infections in preoperatively catheterized patients undergoing TURP at a northern Tanzanian hospital.

Methods

  We conducted a randomized single blinded clinical trial between September 2017 and May 2018. Patients were blinded and randomized into two groups (1:1) according to the duration of antimicrobial course. The patients in the control group received perioperative antibiotics for duration of 8 days and those in the intervention group received perioperative antibiotics for 3 days. Urinalysis and urine culture was done prior, on day 2 and on day 9 to 11 after TURP. All patients were monitored post-operatively for signs and symptoms of infections and followed up to one month post TURP for any sign and symptoms of infectious complications. The incidence of asymtopmatic bacteriuria, symptomatic urinary tract infections (UTI) and clinical sepsis were compared between the two groups.

 Results

A total of 83 patients were enrolled in this study. The mean age was 71.71±10.70 and 74.21±7.7 in short arm and long arm respectively (p=0.24). Both regimens of antibiotic were equally effective. The incidence of bacteriuria at day 9 to 11 after TURP was 40 % in short-term group and 38.7% in long-term group (RR 1.03, 95% CI 0.097 to 2.573). The incidence of symptomatic UTI was 11.4% in short-term group and 9.7% in long-term group (RR 1.27, 95% CI 0.10 to 2.57). None of the patients enrolled in the study developed clinical sepsis and no patients required re-admission during the observation time.

 Conclusion

 A short-term antibiotic course is not inferior to long-term antibiotic course in preventing post-operative infectious complications in catheterized patients undergoing TURP