PMID- 20299078
OWN - NLM
STAT- MEDLINE
DCOM- 20100625
LR  - 20100601
IS  - 1527-9995 (Electronic)
IS  - 0090-4295 (Linking)
VI  - 75
IP  - 6
DP  - 2010 Jun
TI  - Risk of infection after midurethral synthetic sling surgery: are postoperative 
      antibiotics necessary?
PG  - 1305-8
LID - 10.1016/j.urology.2009.11.081 [doi]
AB  - OBJECTIVES: To review our postoperative infections using single-dose preoperative 
      antibiotics. Midurethral synthetic sling surgery is commonly performed. 
      Postoperative antibiotics are often prescribed and may have some risk of adverse 
      events (AEs). We are unaware of data suggesting decreased risk of infection with 
      this practice. METHODS: We reviewed all midurethral synthetic sling surgery 
      charts from 2004 to 2008 performed by 1 surgeon who uses only single-dose 
      preoperative antibiotics (controls), and 2 who also use postoperative 
      antibiotics(cases). A telephone survey was administered, which included questions 
      regarding postoperative infections and AEs related to antibiotic use. Our primary 
      and secondary outcomes were urinary tract infections (UTIs) and AEs related to 
      antibiotic use, respectively. Patients were excluded for bladder injuries, 
      postoperative catheters, and concomitant prolapse surgery. RESULTS: We identified 
      103 cases and 116 controls, and the telephone survey response rate was 81.3%. At 
      baseline, groups had similar characteristics. There was no significant difference 
      in UTIs between cases (6.8%) and controls (9.5%). There were no skin infections. 
      AEs related to antibiotic use were more common among those that received 
      postoperative antibiotics (7.8% vs 0.9%, P=.03). There were 5 (63%) yeast 
      infections, 1 (12.5%) rash, 1 (12.5%) case of nausea, and 1 (12.5%) patient with 
      colitis among cases and 1 yeast infection among controls. CONCLUSIONS: UTI is 
      common after sling surgery, but other infections are rare. The occurrence of UTI 
      does not appear to be lower when postoperative antibiotics are prescribed. 
      However, AEs associated with antibiotic use are increased. These findings do not 
      support the use of postoperative antibiotics.
CI  - Copyright (c) 2010 Elsevier Inc. All rights reserved.
FAU - Swartz, Mia
AU  - Swartz M
AD  - Section of Female Pelvic Medicine and Reconstructive Surgery, Glickman Urological 
      and Kidney Institute, The Cleveland Clinic, Cleveland, Ohio 44195, USA. 
      Mia.addison@gmail.com
FAU - Ching, Christina
AU  - Ching C
FAU - Gill, Bradley
AU  - Gill B
FAU - Li, Jianbo
AU  - Li J
FAU - Rackley, Raymond
AU  - Rackley R
FAU - Vasavada, Sandip
AU  - Vasavada S
FAU - Goldman, Howard B
AU  - Goldman HB
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20100317
PL  - United States
TA  - Urology
JT  - Urology
JID - 0366151
RN  - 0 (Anti-Bacterial Agents)
SB  - IM
CIN - Urology. 2010 Jun;75(6):1308-9; author reply 1309. PMID: 20513491
MH  - Adult
MH  - Anti-Bacterial Agents/*therapeutic use
MH  - Antibiotic Prophylaxis/methods
MH  - Case-Control Studies
MH  - Cohort Studies
MH  - Dose-Response Relationship, Drug
MH  - Drug Administration Schedule
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Middle Aged
MH  - Postoperative Care/*methods
MH  - Probability
MH  - Prosthesis-Related Infections/epidemiology/prevention & control
MH  - Reference Values
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Severity of Illness Index
MH  - Suburethral Slings/*adverse effects
MH  - Treatment Outcome
MH  - *Unnecessary Procedures
MH  - Urinary Incontinence, Stress/diagnosis/surgery
MH  - Urinary Tract Infections/epidemiology/*prevention & control
MH  - Urodynamics
EDAT- 2010/03/20 06:00
MHDA- 2010/06/26 06:00
CRDT- 2010/03/20 06:00
PHST- 2009/07/16 00:00 [received]
PHST- 2009/11/23 00:00 [revised]
PHST- 2009/11/24 00:00 [accepted]
PHST- 2010/03/20 06:00 [entrez]
PHST- 2010/03/20 06:00 [pubmed]
PHST- 2010/06/26 06:00 [medline]
AID - S0090-4295(10)00033-6 [pii]
AID - 10.1016/j.urology.2009.11.081 [doi]
PST - ppublish
SO  - Urology. 2010 Jun;75(6):1305-8. doi: 10.1016/j.urology.2009.11.081. Epub 2010 Mar 
      17.