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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. 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 IV antibiotics at time of the post-surgery catheter removal result in fewer UTI infections in patients post robot-assisted prostatectomy.

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 IDC 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

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