ABSTRACT

The practices regarding the use of antibiotics in common pediatric urology procedures are not clear. Therefore, our practical approaches may vary. This survey aimed to evaluate the antibiotic preferences of surgeons in Turkey in urological procedures commonly performed by pediatric surgeons and pediatric urologists.

Ethical approval was obtained from the local ethics committee on 21.11.2022, with approval number I10-626-22. The survey questions, prepared using Google Forms, were sent via email to pediatric surgery and pediatric urology specialists. The study was completed by 40 surgeons.

90% of the participants were pediatric surgery specialists, and 40% had over 16 years of experience. 40% of the participants worked in university hospitals. The rate of antibiotic use was determined to be 80% before and 90% after surgery in distal hypospadias repairs, and 85% before and 97.5% after surgery in proximal hypospadias repairs. When asked about the selected antibiotic types, first and second-generation cephalosporins were most commonly preferred for hypospadias patients. In pyeloplasty, antibiotic use was 95%, and in patients who underwent laparoscopic exploration for an undescended testicle, it was 57.5%. Inguinal approaches for hernia or hydrocele repairs had a 30% antibiotic use rate, and endourological procedures had a rate of 62.5%. The most commonly preferred antibiotic in patients undergoing bladder augmentation was third-generation cephalosporins (51.3%), followed by aminoglycosides (28.2%). Multiple drug use was most pronounced in bladder augmentation cases.

Similar to the global practice, there is no consensus among pediatric urologists in Turkey regarding the use of prophylactic antibiotics before or after surgery. In order to establish standardized approaches, evidence-based, randomized controlled studies involving large patient groups are needed to develop clear guidelines.

Keywords: Antibiotics, pediatric urology, surgery, prophylaxis