Abstract

"The aim of antimicrobial prophylaxis in urological surgery is to prevent infective complications resulting from diagnostic and therapeutic procedures. However, the evidence on the best choice of antibiotics and prophylactic regimens is limited. There is no evidence for any benefits of antibiotic prophylaxis in standard non-complicated endoscopic procedures and extracorporeal shockwave lithotripsy (ESWL), though it is recommended in complicated procedures and patients with identified risk factors. For open surgery, the same rules as in abdominal surgery can be applied. No antibiotic prophylaxis is required for clean operations, while a single or 1-day dosage is recommended in clean-contaminated operations. Opening of the urinary tract should be considered as clean-contaminated surgery. A single dose or a short course of antimicrobials can be given, either parenterally or orally. The administration route will depend on the type of intervention and patient characteristics. The use of antimicrobials should be based on knowledge of the local pathogen profile and antibiotic susceptibility pattern. Best practice includes surveillance and an audit of infectious complications."

• Keywords: Antibiotic prophylaxis, Surgery