Antibiotic prophylaxys in pediatric surgery of genito-urinary abnormalities

Ninety-two patients in the age range of 2,5 and 16 years with hypospadias (28 cases), vescicorenal reflux (22 cases), hydronephrosis (16 cases) and a series of other congenital genitourinary abnormalities underwent one or more surgical interventions performed by an unique surgeon at the department of Pediatric Surgery, S. Bortolo Hospital, Vicenza. The more frequently performed interventions were the plastic of the urethra (28 pts, 30,4%), that of the pyeloureteral joint (15 pts, 16,3%) and the modelling and the reimplantation of the ureter/ureters (12 pts, 13%). The interventions were considered as clean-contaminated, because all patients had a temporary urinary derivation with vescical catheters, uretral or pyelovescical stents. An antimicrobial prophylaxis was undertaken in all cases in order to prevent postoperatory infections. Ceftriaxone at a mean dosage of 50 mg/kg was administered to all patient for a mean duration of 5,5 days, in 79 cases by the intravenous and in 13 cases by the intramuscular route. Three patients received also metronidazol because of a concomitant intestinal surgery. The objective of this retrospective trial is to evaluate the efficacy of an antibiotic prophylaxis in pediatric genitourinary surgery with temporary urinary drainage. Data analysis evidenced a very low incidence of postoperatory infections, that occurred only in 2 patient on 92. It can be therefore concluded that ceftriaxone is effective and well tolerated when administered for the prevention of postoperative infections in urological interventions.