Antibiotic Prophylaxis in Men Undergoing Transurethral Resection of Prostate: A Systematic Review and Network Meta‐Analysis
Year: 2025
Type: review
Study designs: Systematic Review, Meta-Analysis
Abstract: OBJECTIVES: To analyze the effects of antibiotic prophylaxis (ATBp) prior to transurethral resection of the prostate (TURP) and rank the antibiotic classes. METHODS: We searched PubMed, Web of Science, Embase, CENTRAL, and clinical trials registries for randomized controlled trials (RCTs) from their inceptions through October 2024. We included all RCTs that compared ATBp to placebo or no agent (Plac/No agt) and to each other. Risk ratios (RR), mean differences (MD) and 95% confidence intervals (CI) were estimated by a frequentist network meta-analysis. Treatments were ranked by the surface under the cumulative ranking (SUCRA). RESULTS: We included 45 RCTs (n = 6939), in which ATBp reduced the risk of early (RR: 0.32, CI: 0.28-0.36), and late bacteriuria (RR: 0.50, CI: 0.41-0.62), septicemia/bacteremia (RR: 0.37, CI: 0.26-0.54), fever (RR: 0.60, CI: 0.52-0.70), and length of stay (MD: -0.67, CI: -1.07-[-0.27]) compared to Plac/No agt. Death (RR: 0.62, CI: 0.22-1.76) and adverse effects (RR: 1.33, CI: 0.72-2.46) were nonsignificant. Treatments with the best ranking were: 1st generation cephalosporin plus nitrofuran (early bacteriuria, SUCRA = 0.86), 2nd generation cephalosporin (late bacteriuria, SUCRA = 0.91), lincosamide plus aminoglycoside (septicemia/bacteremia, SUCRA = 0.85), phosphonic (fever, SUCRA = 1.00), lincosamide plus aminoglycoside (length of stay, SUCRA = 1.00), penicillin (death, SUCRA = 0.75), and Plac/No agt (adverse effects, SUCRA = 0.68). CONCLUSIONS: ATBp was superior to Plac/No agt in most endpoints and should be done routinely before TURP with varying effects according to antibiotic classes, which should be considered before adequate prophylaxis.
Source: International Journal of Urology
DOI: 10.1111/iju.70276
Authors: Alessandro V. Oliveira, Ana Luiza N. Sampaio, Edson Luis B. Siqueira, Rui W. Mascarenhas, Regis B. Andriolo
Institution: Universidade do Estado do Pará
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4415789988