ArticleUrologia internationalis2026
Perioperative Gentamicin Prophylaxis in Robot-Assisted Prostatectomy Increases Acute Kidney Injury Risk.
Article in Urologia internationalis, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
<p>Introduction: Aminoglycosides, valued for their lower antimicrobial resistance, are used for perioperative antibiotic prophylaxis (PAP) in urological procedures such as robot-assisted radical prostatectomy (RARP). However, data regarding the safety of gentamicin in robot-assisted surgery remain limited. This study assessed the incidence of acute kidney injury (AKI) associated with PAP with single-dose gentamicin during the transition from open prostatectomy to RARP.
methodsThis single-center, retrospective, matched case-control study included 77 RARP patients receiving gentamicin and 72 matched controls receiving cefuroxime. AKI was assessed using the Kidney Disease: Improving Global Outcome (KDIGO) criteria, considering age, comorbidities, and prostate weight.
resultsAKI occurred in 33.8% of the gentamicin group versus 9.7% of the cefuroxime group, resulting in an odd's ratio (OR) of 6.25. In the gentamicin group, grade 1 AKI was most frequent (19.5%), followed by grade 2 (7.8%) and grade 3 (6.5%). In the cefuroxime group, grades 1 (5.6%) and 2 (4.2%) were observed. Prostate volume and gentamicin use emerged as independent cofactors. Limitations include missing long-term data, variable gland measurements, and inclusion of patients with pre-existing kidney disease.
conclusionThe risk of AKI was significantly higher after PAP with gentamicin compared to PAP with cefuroxime (OR: 6.25, 95% CI: 2.095-18.664, p = 0.001), suggesting that PAP with gentamicin should be avoided in RARP. </p>.
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