Associated measures to antibiotic prophylaxis in urology.

Urinary tract infections are amongst the most frequent nosocomial infections followed by surgical site infections (SSI). Antibiotic prophylaxis is only one way to reduce the risk of post-operative infection. Our aim was to establish a review of the literature on measures to reduce post-operative infections outside antibiotic prophylaxis.

We performed a review of the literature in February 2019 using Medline database to identify relevant studies published in the last 10 years. We arbitrarily decided to fix our limit to the 10 last years considering that the resistance rate of bacteria to antibiotics and the surgical technics evolve over time. This search identified 229 studies. We included 53 studies selected upon the title or the abstract.

Forty-four studies were finally included. We evaluated the efficacy to prevent SSI by skin antisepsis, surgical hand hygiene and technique, type of surgeons' caps, preservation of normothermia, hair removal, increased oxygen delivery, wound protectors, bathing, normoglycemia and immunonutrition.

Antibiotic prophylaxis represents one way to prevent SSI but various other measures should be known and considered by anesthesiologists and surgeons. Some measures to reduce post-operative infections are not clearly established yet and more studies are needed.

World journal of urology. 2019 Jun 28 [Epub ahead of print]

Franck Bruyere, Adrian Pilatz, Axelle Boehm, Benjamin Pradere, Florian Wagenlehner, Maxime Vallee

Urologie, CHU Bretonneau, Tours, France. ., Clinic of Urology, Pediatric Urology and Andrology, Justus Liebig University, Giessen, Germany., Urologie, CHU Bretonneau, Tours, France., Urologie, CHU La Miletrie, Poitiers, France.