Perioperative antimicrobial prophylaxis for preventing infectious complications after transurethral resection of the bladder: to use or not to use?

Purpose Transurethral Resection of the Bladder (TURB) is a very common endoscopic procedure. Perioperative antimicrobial prophylaxis (AMP) is used to reduce the risk of infectious complications. However, there is a lack of knowledge about both incidence of infectious complications after TURB and advantage of AMP in general. The objective of this study is to determinate the prevalence of post-operative infectious complications after routine TURB without AMP. Methods We retrospectively reviewed clinical data of all patients who underwent TURB in the same Academic Urological Department between January 2011 and December 2013. We consider as relevant for analysis, patients that underwent TURB without receiving any AMP. Infection was defined as a body temperature >37.5 °C sustained for at least 24h. Sepsis was defined according to the third international consensus definition for sepsis and septic shock. Results In the period of the study, 223 TURBs were performed without use of AMP. Mean age was 70,3 years (Standard deviation [SD] 11,3). Mean operative time was: 25.14 minutes (SD 16). Median length of hospital stay was 3 days (IQR: 2-4). 6 (2,7%) patients developed postoperative infective complications. No case of sepsis was reported. 2 (0,9%) patients received an antimicrobial therapy with fluoroquinolones despite absence of any signs of infection. 215 (96,4%) patients-TURBs did not receive any antimicrobial drugs and did not developed any infectious complications. Conclusion In our series, infectious complications after TURB occurred in less than 3% of cases. In conclusion AMP should not be routinely used prior TURB.