Effectiveness of postoperative cephalosporins in reducing urinary tract infections and other parameters following transurethral resection of the prostate: a systematic review and meta-analysis

Hafez, Wael; Al-Obeidat, Feras; Rashid, Asrar; Venkatachalapathi, Arun Kumar; Massaod, Amr; AlBaha, Ziad; Kishk, Samy; Emoshe, Tesfalidet; Tefera, Samuel Tesfaye; Ibrahim, Ismail A.; Alkammar, Mohammad; Rashid, Gowhar; Fayed, Ahmed; Soliman, Karim; Nashwan, Abdulqadir J.; Mohamed, Alaaldeen; Simancas-Racines, Daniel; Cherrez-Ojeda, Ivan

Abstract

Background
Transurethral resection of the prostate (TURP) is the standard surgical procedure for alleviating bladder obstruction caused by benign prostatic hyperplasia (BPH). Although effective, TURP is associated with the risk of urinary tract infection (UTI), which may be reduced by postoperative cephalosporin use.
Objective
This study aimed to determine the efficacy of cephalosporins in reducing the risk and complications of UTI following TURP.
Methods
The MEDLINE, Embase, and Cochrane Central databases were searched for randomized controlled trials (RCTs) that compared cephalosporin antibiotics with no intervention in patients undergoing TURP. The outcomes of interest for this systematic review and meta-analysis were UTI, length of stay, adverse effects, and postoperative days. Evaluations were reported as risk ratios (RR) and mean differences (MD) with 95% confidence intervals, using weighted random-effects models.
Results
The Data Analysis included 668 participants from seven RCTs. Postoperative cephalosporin treatment after TURP significantly reduced the incidence of UTI compared with that in the control group (OR 0.37, 95% CI [0.22, 0.61], P<0.001, I²=30%). However, no significant difference was observed between postoperative cephalosporin use and the length of stay (MD -0.36, 95%CI [-1.13, 0.40], P=0.35, I²=81%), postoperative days (MD 0.20, 95% CI [-0.12, 0.53], P=0.22, I²=74%), and rate of adverse events (OR 0.94, 95% CI [0.58, 1.51], P=0.79; I²=0%).
Conclusion
Cephalosporins effectively reduced the risk of UTI in patients undergoing TURP. Further research in this field is warranted to determine the efficacy of other antibiotics individually and provide a better comparison to implement standardized practices.

Citation

Hafez, W., Al-Obeidat, F., Rashid, A., Venkatachalapathi, A. K., Massaod, A., AlBaha, Z., Kishk, S., Emoshe, T., Tefera, S. T., Ibrahim, I. A., Alkammar, M., Rashid, G., Fayed, A., Soliman, K., Nashwan, A. J., Mohamed, A., Simancas-Racines, D., & Cherrez-Ojeda, I. (2025). Effectiveness of postoperative cephalosporins in reducing urinary tract infections and other parameters following transurethral resection of the prostate: a systematic review and meta-analysis. Current Problems in Surgery, 63, Article 101696. https://doi.org/10.1016/j.cpsurg.2024.101696

• Journal Article Type: Article
• Acceptance Date: Dec 10, 2024
• Online Publication Date: Dec 18, 2024
• Publication Date: 2025-02
• Deposit Date: Jan 6, 2025
• Publicly Available Date: Jan 6, 2025
• Journal: Current Problems in Surgery
• Print ISSN: 0011-3840
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 63
• Article Number: 101696
• DOI: https://doi.org/10.1016/j.cpsurg.2024.101696