Effectiveness of Three Times of Starting Antibiotic Prophylaxis in Patients With Asymptomatic Bacteriuria.
Effectiveness of Three Times of Starting Antibiotic Prophylaxis in Patients With Asymptomatic Bacteriuria.
Asymptomatic bacteriuria (AB) is the isolation of a bacterium in a sample of urine
 appropriately collected from a person who does not have signs or symptoms of urinary
 infection. It is common in diabetic women, in pregnant women, in men over 60 years and in
 patients with spinal cord injury.

 There is clinical evidence that AB should be treated in patients who will be operated on with
 urologic surgery because of the risk of presenting infectious complications; however, the
 timing of initiating antibiotic therapy has not been established, even in some studies the
 prophylaxis has been considered from one to seven days prior to the procedure, without
 determining the differences in the outcome for each one of the interventions and causing an
 undue and risky use of antibiotics.

 A randomized, parallel-design, single-masked clinical trial will be performed to compare and
 analysis the bloodstream infections, surgical site infections, readmissions and hospital stay
 in three intervention groups, 1) those receiving antibiotics during the previous 5 days to
 the procedure; 2) 3 days prior to the procedure; and 3) those who receive only a single dose
 of antibiotic on the day of the procedure.

 The main expected result is to identify the timing of initiation of antibiotic prophylaxis in
 urological procedures in patients with asymptomatic bacteriuria, with the purpose of
 diminishing the bloodstream and of the surgical site infections. If it is scientifically
 demonstrated that those patients who receive a single dose of antibiotic on the same day of
 the procedure, have the same safety and effectiveness compared to the other two groups, would
 reduce hospital stay, surgical waiting time and indiscriminate use of antibiotics that
 generate multidrug-resistant microorganisms, thus generating an impact on Public Health and
 on the quality of care.
Inclusion Criteria:

 -  Age ≥ 18 years

 -  Patients with asymptomatic bacteriuria identified with a urine culture prior to the
 surgical procedure and with a microorganism that meets the following criteria: 1)
 gram-negative bacteria in the enterobacterial family and non-fermenting bacilli; 2)
 Bacteria with resistance profile has a therapeutic option that reaches therapeutic
 concentration in urine.

 -  Patients scheduled for urological procedures, such as: transurethral resection of the
 prostate, open prostatectomy, cystoscopy, extracorporeal lithotripsy and flexible
 ureterorenoscopy.

 -  Informed consent

 Exclusion Criteria:

 -  Patients with chronic renal failure; with immunosuppressive status secondary to
 glucocorticoid consumption, haematological or solid organ neoplasms undergoing
 chemotherapy or radiation therapy or neutropenia.

 -  Patients with active infection or clinical criteria of urinary infection.

 -  Patients who voluntarily do not want to participate in the study.

 -  Patients who can not give informed consent under reasonable or vulnerable conditions.

 -  Patients who present type I allergy to penicillin.

 -  Patients who have scheduled surgeries combined with a discipline different to urology.