Antibiotic Prophylaxis with Trimethoprim-Sulfamethoxazole versus No Treatment after Mid-to-Distal Hypospadias Repair: A Prospective, Randomized Study
Purpose. To evaluate the impact of prophylactic antibiotics after distal hypospadias repair on postoperative bacteriuria, symptomatic urinary tract infection, and postoperative complications in a prospective, randomized trial. Materials and Methods. Consecutive patients aged 6 months to 2 years were...
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Advances in Urology |
| Online Access: | http://dx.doi.org/10.1155/2018/7031906 |
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| author | Elizabeth B. Roth John V. Kryger Charles T. Durkee Melissa A. Lingongo Ruth M. Swedler Travis W. Groth |
| author_facet | Elizabeth B. Roth John V. Kryger Charles T. Durkee Melissa A. Lingongo Ruth M. Swedler Travis W. Groth |
| author_sort | Elizabeth B. Roth |
| collection | DOAJ |
| description | Purpose. To evaluate the impact of prophylactic antibiotics after distal hypospadias repair on postoperative bacteriuria, symptomatic urinary tract infection, and postoperative complications in a prospective, randomized trial. Materials and Methods. Consecutive patients aged 6 months to 2 years were enrolled at our institution between June 2013 and May 2017. Consenting patients were randomized to antibiotic prophylaxis with trimethoprim-sulfamethoxazole versus no antibiotic. Patients had catheterized urine samples obtained at surgery and 6–10 days postoperatively. The primary outcome was bacteriuria and pyuria at postoperative urine collection. Secondary outcomes included symptomatic urinary tract infection and postoperative complications. Results. 70 patients consented to the study, of which 35 were randomized to receive antibiotics compared to 32 who did not. Demographics, severity of hypospadias, and type of repair were similar between the groups. Patients in the treatment group had significantly less pyuria (18%) and bacteriuria (11%) present at stent removal compared to the nontreatment group (55% and 63%; p=0.01 and p<0.001, resp.). No patient had a symptomatic urinary tract infection. There were 11 postoperative complications. Conclusions. Routine antibiotic prophylaxis appears to significantly decrease bacteriuria and pyuria in the immediate postoperative period; however, no difference was observed in symptomatic urinary tract infection or postoperative complications. Clinical Trial Registration Number NCT02593903. |
| format | Article |
| id | doaj-art-c6c2db717c7a41478b1e6407eff34b06 |
| institution | OA Journals |
| issn | 1687-6369 1687-6377 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Advances in Urology |
| spelling | doaj-art-c6c2db717c7a41478b1e6407eff34b062025-08-20T02:19:44ZengWileyAdvances in Urology1687-63691687-63772018-01-01201810.1155/2018/70319067031906Antibiotic Prophylaxis with Trimethoprim-Sulfamethoxazole versus No Treatment after Mid-to-Distal Hypospadias Repair: A Prospective, Randomized StudyElizabeth B. Roth0John V. Kryger1Charles T. Durkee2Melissa A. Lingongo3Ruth M. Swedler4Travis W. Groth5Division of Pediatric Urology, Department of Urology, Medical College of Wisconsin, Children’s Hospital of Wisconsin, Milwaukee, WI, USADivision of Pediatric Urology, Department of Urology, Medical College of Wisconsin, Children’s Hospital of Wisconsin, Milwaukee, WI, USADivision of Pediatric Urology, Department of Urology, Medical College of Wisconsin, Children’s Hospital of Wisconsin, Milwaukee, WI, USADivision of Pediatric Urology, Department of Urology, Medical College of Wisconsin, Children’s Hospital of Wisconsin, Milwaukee, WI, USADivision of Pediatric Urology, Department of Urology, Medical College of Wisconsin, Children’s Hospital of Wisconsin, Milwaukee, WI, USADivision of Pediatric Urology, Department of Urology, Medical College of Wisconsin, Children’s Hospital of Wisconsin, Milwaukee, WI, USAPurpose. To evaluate the impact of prophylactic antibiotics after distal hypospadias repair on postoperative bacteriuria, symptomatic urinary tract infection, and postoperative complications in a prospective, randomized trial. Materials and Methods. Consecutive patients aged 6 months to 2 years were enrolled at our institution between June 2013 and May 2017. Consenting patients were randomized to antibiotic prophylaxis with trimethoprim-sulfamethoxazole versus no antibiotic. Patients had catheterized urine samples obtained at surgery and 6–10 days postoperatively. The primary outcome was bacteriuria and pyuria at postoperative urine collection. Secondary outcomes included symptomatic urinary tract infection and postoperative complications. Results. 70 patients consented to the study, of which 35 were randomized to receive antibiotics compared to 32 who did not. Demographics, severity of hypospadias, and type of repair were similar between the groups. Patients in the treatment group had significantly less pyuria (18%) and bacteriuria (11%) present at stent removal compared to the nontreatment group (55% and 63%; p=0.01 and p<0.001, resp.). No patient had a symptomatic urinary tract infection. There were 11 postoperative complications. Conclusions. Routine antibiotic prophylaxis appears to significantly decrease bacteriuria and pyuria in the immediate postoperative period; however, no difference was observed in symptomatic urinary tract infection or postoperative complications. Clinical Trial Registration Number NCT02593903.http://dx.doi.org/10.1155/2018/7031906 |
| spellingShingle | Elizabeth B. Roth John V. Kryger Charles T. Durkee Melissa A. Lingongo Ruth M. Swedler Travis W. Groth Antibiotic Prophylaxis with Trimethoprim-Sulfamethoxazole versus No Treatment after Mid-to-Distal Hypospadias Repair: A Prospective, Randomized Study Advances in Urology |
| title | Antibiotic Prophylaxis with Trimethoprim-Sulfamethoxazole versus No Treatment after Mid-to-Distal Hypospadias Repair: A Prospective, Randomized Study |
| title_full | Antibiotic Prophylaxis with Trimethoprim-Sulfamethoxazole versus No Treatment after Mid-to-Distal Hypospadias Repair: A Prospective, Randomized Study |
| title_fullStr | Antibiotic Prophylaxis with Trimethoprim-Sulfamethoxazole versus No Treatment after Mid-to-Distal Hypospadias Repair: A Prospective, Randomized Study |
| title_full_unstemmed | Antibiotic Prophylaxis with Trimethoprim-Sulfamethoxazole versus No Treatment after Mid-to-Distal Hypospadias Repair: A Prospective, Randomized Study |
| title_short | Antibiotic Prophylaxis with Trimethoprim-Sulfamethoxazole versus No Treatment after Mid-to-Distal Hypospadias Repair: A Prospective, Randomized Study |
| title_sort | antibiotic prophylaxis with trimethoprim sulfamethoxazole versus no treatment after mid to distal hypospadias repair a prospective randomized study |
| url | http://dx.doi.org/10.1155/2018/7031906 |
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