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Reducing Risk of Catheter-Acquired UTI Post-Prostatectomy

Reducing Risk of Catheter-Acquired UTI Post-Prostatectomy

Project Overview

Catheter acquired urinary tract infections are one of the most common health care acquired infections. The daily acquisition of bacteriuria with an indwelling catheter (IDC) in-situ is 3-7%

Exposure to antibiotics with an IDC insitu may lead to the development of multi-resistant organisms. Acute IDC-related urinary tract infections have been reported in 3.2-12%, with the incidence increasing the longer the IDC remains insitu. The most common organism isolated from urine cultures is E. coli.

A robot-assisted radical prostatectomy is the most common surgical procedure for prostate cancer management in private patients in Queensland and Australia. An IDC is left insitu, usually for 7 days post-operatively to allow for healing. The role of an antibiotic at the time of trial of void (TOV) remains controversial and the available data is insufficient for evidence based validity. 

Proponents of antibiotics state a significant risk of bacteriuria with an IDC insitu for 7 days and the risk of a clinical urinary tract infection (UTI) if prophylactic antibiotics are not used during the catheterisation period, or at trial of void. A UTI results in patient morbidity and occasionally the need for hospital re-admission.

By contrast, the opponents of antibiotics at TOV state the low risk of clinical infection and the possible emergence of multi-resistant strains of bacteria with widespread antibiotic use. There is also a cost to the community and health funds with funding the day case admission for the antibiotic administration.

Will giving patients a dose of antibiotics at the time of catheter removal reduce the risk of developing a UTI?

Patients Required

Estimated completion

Sept 2021

Total Patients

870

Study Location

The Wesley Hospital

Project Aim

The primary aim of the study is to define whether a single dose of intravenous antibiotic at the time of trial of void following a robot-assisted radical prostatectomy will decrease the risk of a symptomatic Indwelling Catheter related UTI.

The control group will undertake a TOV without antibiotic prophylaxis and the treatment group will receive a single dose of intravenous antibiotic at TOV.

Project Impact

If successful, it will mean that patients who undergo a robot-assisted radical prostatectomy will be given the clinically proven best solution to ensure that their recovery is faster, safer and has less post-surgical complications due to UTIs caused by indwelling catheter removal.

Researchers

Assoc Prof John Yaxley
Urological Surgeon

This trial means that patients at the Wesley Hospital will receive an evidence-based approach to post-operative care after their robot-assisted radical prostatectomy.

AProf John Yaxley, Lead Researcher

Presentations & Events

Prostate Cancer Research: Targeting Improvements in Men’s Health

Urologist Dr John Yaxley is actively involved in research into improving the outcomes for men with prostate cancer.

In August 2019, he presented at Wesley Medical Research on the findings from a number of studies he has led and been involved with.

He also detailed a study currently underway which looks at improving the postoperative outcomes for patients after radical prostatectomy.

Watch the full presentation here >>

Play Video

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Wesley Medical Research

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