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Therapeutic failures of targeted antibiotic prophylaxis in urology

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Abstract

Targeted antibiotic prophylaxis (TAP) is required for patients with positive urine culture before urological surgery. Our aim was to determine the efficacy of TAP. This was a prospective single-center study performed in a urology department. All patients who underwent a programmed surgery were included. Urine culture was obtained before surgery requiring a prophylaxis: in the case of sterile urines, antibiotics were used in accordance with national recommendations; for positive urine culture, a TAP was used in accordance with susceptibility testing. The drugs were administered for 2 days before surgery until withdrawal of bladder catheter. The occurrence of healthcare-associated infections was registered until day 30 after surgery. Two hundred three patients were included for 8 non-consecutive weeks in 2020, among whom fifteen were lost of sight before day 30. Among the remaining 188 patients, most frequent surgeries were 75 prostatic diseases (40%), 50 endo-ureteral surgeries for JJ stent insertion (27%), and 23 bladder cancers (12%). One hundred forty-eight (79%) patients required a urine culture before procedure; 142/148 (96%) urine cultures were performed, leading to 74 TAP. The main isolated bacteria were 48 Enterobacteriaceae and 8 Enterococcus spp. TAP was cotrimoxazole (n = 30), aminoglycosides (n = 11), amoxicillin (n = 9), fluoroquinolones (n = 7), and others (n = 17). The rate of healthcare-associated infections was 14.8% (11/74), including six microbiologically documented antibiotic failures. The rate of healthcare-associated infection after urological surgery using TAP was high, implying to discuss the choice and the dosage of the antibiotic molecules.

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Data availability

The data used during the current study is available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Infectiologie, Centre Hospitalier Universitaire de Guadeloupe, Guadeloupe, France

    Elodie Curlier, Samuel Markowicz, Sunniva Donat & Pierre-Marie Roger

  2. Urologie, Centre Hospitalier Universitaire de Guadeloupe, Guadeloupe, France

    Yvanne Sadreux, Laurent Brureau & Pascal Blanchet

  3. Faculté de Médecine, Université Des Antilles, Pointe-à-Pitre, Guadeloupe, France

    Yvanne Sadreux, Laurent Brureau, Pascal Blanchet & Pierre-Marie Roger

Authors
  1. Elodie Curlier
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  2. Yvanne Sadreux
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  3. Samuel Markowicz
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  4. Laurent Brureau
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  5. Sunniva Donat
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  6. Pascal Blanchet
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  7. Pierre-Marie Roger
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Contributions

All authors contributed significantly to the study, and all have read and consent to the article.

Corresponding author

Correspondence to Pierre-Marie Roger.

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Ethics approval

The antibiotic audit was sponsored by the French National Health Agency.

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The patients or their relatives provided written consent for computerization of their personal data for hospitalization purposes and clinical research. Patient privacy was protected as no personal data were extracted or copied from the computerized chart.

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The authors declare no competing interests.

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Curlier, E., Sadreux, Y., Markowicz, S. et al. Therapeutic failures of targeted antibiotic prophylaxis in urology. Eur J Clin Microbiol Infect Dis 41, 299–304 (2022). https://doi.org/10.1007/s10096-021-04329-9

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  • DOI: https://doi.org/10.1007/s10096-021-04329-9

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