The state of antimicrobial prophylaxis for transurethral resection

In the urological operative field, antimicrobial prophylaxis seems to be important when performing a transurethral resection in order to prevent perioperative febrile urinary tract infection and urosepsis. In order to draw up the original Japanese guidelines for antimicrobial prophylaxis, the Japanese Urological Association(JUA) established the working group and accomplished the drawing up of the new guidelines, which were published in the Journal of Japanese Urology in 2006. Then 5 years later, in order to examine the validity of our Japanese guidelines, we sent out questionnaires to urological surgeons which asked about the rates of agreement between the antibiotics they were administering and the guidelines-recommended antibiotics, and also regarding the incidence of perioperative infections. For transurethral resection of the prostate(TUR-P), the questionnaires were sent out to 100 members of the JUA and there were 75 respondents (response rate of 75%). The rate of agreement with the Japanese guideline was 79.6%, and the rate of perioperative infections in 92.3% of the respondents' institutes was less than 5%. For transurethral resection of bladder tumors(TUR-Bt), the questionnaires were sent out to 114 members of the JUA and there were 89 respondents (response rate of 78.1%). The rate of agreement with the Japanese guideline was 77.6%, and the rate of perioperative infections in 95.4% of the respondents' institutes was less than 5%. The results of the same questionnaire survey, which were examined in 1995, demonstrated that we could not prevent the occurrence of about 5% perioperative infections against more than 7 days' antimicrobial prophylaxis. In accordance with previous data, we can accept appropriate antimicrobial prophylaxis, if the prophylaxis suppresses the occurrence of perioperative infections to less than 5%. This study has shown that the antimicrobial prophylaxis for transurethral resection suggested by the Japanese guidelines was appropriate.