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Prophylactic Cefuroxim Reduces Risk of UTI Within 7 Days After Pelvic Organ Prolapse Surgery: Presented at ICS

By Sandra Ripley Distelhorst

SAN FRANCISCO -- October 2, 2009 -- A single prophylactic dose of cefuroxim 1.5 g given to women undergoing pelvic organ prolapse (POP) surgery can reduce the risk of urinary tract infection (UTI) within 7 days after surgery, researchers reported here at the 39th Annual Meeting of the International Continence Society (ICS).

Marianne Ottesen Weincke, MD, Department of Obstetrics and Gynecology, Hvidovre University Hospital, Hvidovre, Denmark, presented results from a randomised controlled trial on October 1.

Previous studies have shown that prophylactic antibiotics given at the time of vaginal hysterectomy can reduce the risk of postoperative infections. "We looked to see if this would also hold true for simple pelvic organ prolapse surgery," Dr. Weincke said.

The final analysis included 99 women who underwent POP surgery. Patients were randomised to receive cefuroxim 1.5 g (n = 51 patients) or no treatment (n = 48). Urine samples were collected at day 1, pre- and postoperatively, day 7, and day 30.

Baseline patient characteristics were similar between groups. Data were also collected on surgery time, surgery extent, and blood loss and were found to be similar for both groups.

Results showed a significant decrease in cumulative risk for urinary tract within 7 days of surgery for patients who received a single dose of cefuroxim 1.5 g (P = .01).

However, the study did not find a significant difference in a protective effect of cefuroxim at 30 days for UTIs (P = .28), or other infections at 30 days (P = .63).

The study did find that smoking significantly increased the risk of other infections such as wound infection, febrile episodes, and pneumonia within 30 days after simple POP surgery (P = .01)

"We recommend the use of a single dose of 1.5 g of cefuroxim intraoperatively for simple pelvic prolapse surgery to reduce the risk of urinary tract infection within the first 7 days after surgery," Dr. Weincke said.

"Women who smoke should be informed that smoking increases their risk of postoperative infections and should be advised to quit smoking before surgery."

[Presentation title: A Randomized Controlled Trial on Prophylactic Antibiotics and Pelvic Organ Prolapse Surgery. Abstract 10]

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