Exstrophy and Epispadias Medication

Updated: Jul 26, 2016
  • Author: Elizabeth B Yerkes, MD; Chief Editor: Marc Cendron, MD  more...
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Medication

Medication Summary

Antibiotics are given to prevent urinary tract infections in patients with exstrophy and epispadias.

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Broad-spectrum antibiotics

Class Summary

These agents are used for prevention of perioperative tissue infection due to preoperative colonization of urinary tract or multiple indwelling catheters.

Ampicillin (Marcillin, Omnipen, Polycillin)

Bactericidal activity against susceptible organisms. Started at birth in classic bladder exstrophy or cloacal exstrophy and continued through early postoperative period.

Gentamicin (Garamycin)

Aminoglycoside antibiotic for gram-negative coverage. Started at birth in classic bladder exstrophy or cloacal exstrophy and continued through early postoperative period.

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Prophylactic antibiotics

Class Summary

These agents are used for prevention of urinary tract infection in light of vesicoureteral reflux and possible inefficient bladder emptying.

Amoxicillin (Trimox, Amoxil, Biomox)

First-line choice for prophylaxis in newborns. Interferes with synthesis of cell wall mucopeptides during active multiplication, resulting in bactericidal activity against susceptible bacteria. Used as prophylaxis in certain PO, GI, or genitourinary procedures.

Trimethoprim-sulfamethoxazole (Bactrim, Septra, Cotrim)

Inhibits bacterial growth by inhibiting synthesis of dihydrofolic acid. Switch from amoxicillin to TMP-SMZ after 2 mo; can dispense larger supply, making refills more convenient; susp contains 20 mg TMP and 100 mg SMZ per 5 mL; prophylactic dose is one half therapeutic dose.

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