EUROPEAN COLLABORATIVE STUDY OF ANTIBIOTIC-PROPHYLAXIS FOR TRANSURETHRAL RESECTION OF THE PROSTATE

A prospective randomised trial was undertaken in nine European Hospita ls to test antibiotic prophylaxis for men undergoing transurethral res ection of the prostate. Of the men with no significant growth (< 10(4) cfu ml-1) in their preoperative urine, 247 received a single 1-gramme dose of ceftazidime with the induction of anaesthesia, 256 received 1 g daily from the time of induction of anaesthesia until removal of th e urethral catheter (but less-than-or-equal-to 5 days) and 261 receive d no prophylaxis. Of evaluable patients 83 (33.9%), 45 (18.7%) and 29 (11.6%) of the no-prophylaxis, single-dose and multidose groups, respe ctively, developed urinary tract infection in the immediate post-opera tive period. There were significantly fewer febrile episodes and fewer prescriptions for alternative antibiotics in the ceftazidime-treated groups. Four men developed peri-operative septicaemia and all were in the no-prophylaxis group. We conclude that patients, even those with c ulture-negative urine pre-operatively, benefit from antibiotic prophyl axis and that antibiotic prophylaxis should be considered for all men undergoing prostatic surgery as a routine procedure.