Summary
Introduction
Judicious use of antibiotics for surgical prophylaxis is important for reducing antimicrobial
resistance while preventing infectious surgical complications. In the setting of pediatric
distal hypospadias repairs, it is unclear if antibiotic surgical prophylaxis is beneficial.
Objective
The purpose of this study was to compare rates of infectious complications in pediatric
subjects undergoing distal hypospadias repair who received any peri-operative antibiotics
to those who did not.
Study design
This was a review of a retrospective cohort from a database of individuals undergoing
hypospadias repairs evaluating whether they received peri-operative or post-operative
antibiotic prophylaxis and determining the rate of infectious complications in those
who did compared to those who did not receive antibiotic prophylaxis. Infectious complications
were defined as surgical site infection (SSI) or urinary tract infection (UTI).
Results
There was no significant difference in infectious complication rates between individuals
who received peri-operative parenteral antibiotic prophylaxis and those who did not.
All subjects with infectious complications received post-operative oral antibiotic
prophylaxis. There was one instance of C. difficile infection in a subject who received peri-operative parenteral antibiotics.
Discussion
Reducing antibiotic utilization without increasing infectious surgical complications
is important in safely reducing antimicrobial resistance. In this study of pediatric
distal hypospadias repair, peri-operative antibiotics did not demonstrate a clear
benefit and post-operative oral antibiotics demonstrated no benefit in preventing
infectious complications. Other studies evaluating peri- and post-operative antibiotics
for pediatric hypospadias repair have also failed to demonstrate a benefit for antibiotics
in preventing infections. Practitioners should reconsider the use of antibiotics in
this setting.
Conclusion
Routine antibiotic prophylaxis does not appear beneficial for preventing infectious
complications following uncomplicated, stented pediatric distal hypospadias repairs.
Keywords
Abbreviations:
BCH (Boston Children's Hospital), IRB (Institutional Review Board), MAGPI (meatal advancement and glanuloplasty), PO (Per Os), SSI (Surgical Site Infection), TIP (Tubularized Incised Plate), UTI (Urinary Tract Infection)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: May 13, 2022
Accepted:
May 6,
2022
Received in revised form:
April 19,
2022
Received:
February 14,
2022
Identification
Copyright
© 2022 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Commentary to ‘Is parenteral antibiotic prophylaxis associated with fewer infectious complications stented, distal hypospadias repair?’Journal of Pediatric UrologyVol. 18Issue 6
- PreviewIn this report, Doersch and co-authors address the controversy of the use of antibiotics for hypospadias repair [1]. The two reasons to consider antibiotic prophylaxis during hypospadias repair are to reduce wound infections and symptomatic urine infections associated with a catheter. Both of these are quite uncommon, as shown in this study reporting only a single infectious complication in 100 boys undergoing distal repairs without preoperative parenteral antibiotics, and no infections in those not receiving postoperative antibiotics.
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