Skip to main content

A single-dose regimen for antimicrobial prophylaxis to prevent perioperative infection in urological clean and clean-contaminated surgery


A single dose of antimicrobial prophylaxis (AMP) was administered parenterally for the prevention of perioperative infection in a total of 788 patients undergoing urological surgery, including 380 endoscopic-instrumental, 328 clean, and 80 clean-contaminated operations performed at our institute between January 2007 and December 2009. Surgical site infections (SSIs), urinary tract infections (UTIs), and remote infections (RIs) were prospectively surveyed. The definition for a single dose of AMP allowed for the administration of an additional dose of an antimicrobial during surgery if the procedure was longer than 3 h, but not for the parenteral or oral administration at the end of the procedure in the recovery room, or at a later time over a period of more than 24 h. UTI was observed in 12 (3.2%) patients after endoscopic-instrumental operation, 1 (0.3%) after clean operation, and 1 (0.9%) after clean-contaminated operation. SSI was observed in 2 (0.6%) patients after clean operation but in none after clean-contaminated operations. RI was observed in 1 (0.3%) patient after endoscopic-instrumental operation, 3 (0.9%) after clean operation, and none after clean-contaminated operations. A single-dose regimen of AMP was effective and feasible for the prevention of perioperative infections, including SSIs, UTIs, and RIs, in endoscopic-instrumental, clean, and clean-contaminated urological surgical procedures.

This is a preview of subscription content, access via your institution.


  1. Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guideline for prevention of surgical site infection, 1999. Infect Cont Hosp Epidemiol. 1999;20:250–78.

    Article  CAS  Google Scholar 

  2. Naber KG, Bergman B, Bishop MC, Bjerklund-Johansen TE, Botto H, Lobel B, et al. EAU guidelines for the management of urinary and male genital tract infections. Urinary Tract Infection (UTI) Working Group of the Health Care Office (HCO) of the European Association of Urology (EAU). Eur Urol. 2001;40:576–88.

    PubMed  Article  CAS  Google Scholar 

  3. Grabe M. Controversies in antibiotic prophylaxis in urology. Int J Antimicrob Agents. 2004;23(Suppl 1):S17–23.

    PubMed  Article  CAS  Google Scholar 

  4. Matsumoto T, Kiyota H, Matsukawa M, Yasuda M, Arakawa S, Monden K; Japanese Society of UTI Cooperative Study Group (Chairman; Tetsuro Matsumoto). Japanese guidelines for prevention of perioperative infections in urological field. Int J Urol. 2007;14:890–909.

    PubMed  Article  Google Scholar 

  5. Wolf JS Jr, Bennett CJ, Dmochowski RR, Hollenbeck BK, Pearle MS, Schaeffer AJ. Best practice policy statement on urologic surgery antimicrobial prophylaxis. J Urol. 2008;179:1379–90.

    PubMed  Article  Google Scholar 

  6. Berry A, Barratt A. Prophylactic antibiotic use in transurethral prostatic resection: a meta-analysis. J Urol. 2002;167:571–7.

    PubMed  Article  Google Scholar 

  7. Qiang W, Jianchen W, MacDonald R, Monga M, Wilt TJ. Antibiotic prophylaxis for transurethral prostatic resection in men with preoperative urine containing less than 100,000 bacteria per ml: a systematic review. J Urol. 2005;173:1175–81.

    PubMed  Article  Google Scholar 

  8. Rodríguez LV, Terris MK. Risks and complications of transrectal ultrasound guided prostate needle biopsy: a prospective study and review of the literature. J Urol. 1998;160:2115–20.

    PubMed  Article  Google Scholar 

  9. Webb NR, Woo HH. Antibiotic prophylaxis for prostate biopsy. BJU Int. 2002;89:824–8.

    PubMed  Article  CAS  Google Scholar 

  10. Kanamaru S, Terai A, Ishitoya S, Kunishima Y, Nishiyama H, Segawa T, et al. Assessment of a protocol for prophylactic antibiotics to prevent perioperative infection in urological surgery: a preliminary study. Int J Urol 2004;11:355–63.

    PubMed  Article  Google Scholar 

  11. Yamamoto S, Kanamaru S, Kunishima Y, Ichiyama S, Ogawa O. Perioperative antimicrobial prophylaxis in urology: a multi-center prospective study. J Chemother. 2005;17:189–97.

    PubMed  CAS  Google Scholar 

  12. Terai A, Ichioka K, Kohei N, Ueda N, Utsunomiya N, Inoue K. Antibiotic prophylaxis in radical prostatectomy: 1-day versus 4-day treatments. Int J Urol. 2006;13:1488–93.

    PubMed  Article  CAS  Google Scholar 

  13. Yoshida S, Masuda H, Yokoyama M, Kobayashi T, Kawakami S, Kihara K. Absence of prophylactic antibiotics in minimum incision endoscopic urological surgery (MEUS) of adrenal and renal tumors. Int J Urol. 2007;14:384–7.

    PubMed  Article  Google Scholar 

  14. Sakura M, Kawakami S, Yoshida S, Masuda H, Kobayashi T, Kihara K. Prospective comparative study of single dose versus 3-day administration of antimicrobial prophylaxis in minimum incision endoscopic radical prostatectomy. Int J Urol. 2008;15:328–31.

    PubMed  Article  Google Scholar 

  15. Trinchieri A, Paparella S, Cappoli S, Esposito N, Butti A, Vaiani R, et al. Prospective assessment of the efficacy of the EAU guidelines for the prevention of nosocomial acquired infections after genitourinary surgery in a district hospital. Arch Ital Urol Androl. 2009;81:46–50.

    PubMed  Google Scholar 

  16. Takahashi S, Takeyama K, Miyamoto S, Tanuma Y, Takagi Y. Surgical antimicrobial prophylaxis in transurethral ureterolithotripsy. J Infect Chemother. 2005;11:239–43.

    PubMed  Article  Google Scholar 

  17. Matsukawa M, Kunishima Y, Takahashi S, Takeyama K, Tsukamoto T. Staphylococcus aureus bacteriuria and surgical site infections by methicillin-resistant Staphylococcus aureus. Int J Antimicrob Agents. 2001;17:327–30.

    PubMed  Article  CAS  Google Scholar 

  18. Hara N, Kitamura Y, Saito T, Komatsubara S, Nishiyama T, Takahashi K. Perioperative antibiotics in radical cystectomy with ileal conduit urinary diversion: efficacy and risk of antimicrobial prophylaxis on the operation day alone. Int J Urol. 2008;15:511–5.

    PubMed  Article  Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Shingo Yamamoto.

About this article

Cite this article

Higuchi, Y., Takesue, Y., Yamada, Y. et al. A single-dose regimen for antimicrobial prophylaxis to prevent perioperative infection in urological clean and clean-contaminated surgery. J Infect Chemother 17, 219–223 (2011).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:


  • Antimicrobial prophylaxis
  • Urological surgery
  • Surgical site infection