Antibiotic prophylaxis for urinary catheter manipulation following arthroplasty: a systematic review.

Roberts, Tobias, Smith, Toby, Simon, H, Goodmaker, C and Hing, Caroline (2020) Antibiotic prophylaxis for urinary catheter manipulation following arthroplasty: a systematic review. ANZ Journal of Surgery. ISSN 1445-1433 (In Press)

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Background: urinary catheter use in the peri- and post-operative phase following arthroplasty may be associated with urinary tract infection (UTI) and deep prosthetic joint infection (PJI). These can be catastrophic complications in joint arthroplasty. We performed a systematic review of the evidence on use of antibiotics for urinary catheter insertion and removal following arthroplasty. Methods: Electronic databases were searched using the HDAS interface. Grey literature was searched. From 219 citations, 6 studies were deemed eligible for review. Due to study heterogeneity a narrative approach was adopted. Methodological quality of each study was assessed using the CASP appraisal tool. Results: 4696 hip and knee arthroplasties were performed on 4578 participants across all studies. Of these 1475 (31%) were on men and 3189 (68%) on women. Mean age of study participants was 69 years. 3489 cases (74.3%) related to hip arthroplasty and 629 (13.4%) to knee arthroplasty. 578 (12.3%) were either hip or knee arthroplasty. 45 PJIs were reported across all studies (0.96%). Two studies found either no PJI or no statistical difference in the rate of PJI when no antibiotic prophylaxis was used for catheter manipulation. Another study found no statistical difference in PJI rates between patients with or without preoperative bacteriuria. Where studies report potential haematogenous spread from UTIs, this association can only be assumed. Increased duration of urinary catheterisation is positively associated with UTI. Conclusion: It remains difficult to justify the use of prophylactic antibiotics for catheter manipulation in well patients. Their use is not recommended for this indication.

Item Type: Article
Uncontrolled Keywords: uti,infection,arthoplasty,prophylaxis,antibiotic
Faculty \ School: Faculty of Medicine and Health Sciences > School of Health Sciences
Depositing User: LivePure Connector
Date Deposited: 05 Jan 2021 00:57
Last Modified: 05 Jan 2021 00:57

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