Journal article
Minimizing Antibiotic Use in Urethral Reconstruction
The Journal of urology, Vol.208(1), pp.128-134
07/2022
DOI: 10.1097/JU.0000000000002487
PMID: 35212569
Abstract
There are no established guidelines regarding management of antibiotics for patients specifically undergoing urethral reconstruction. Our aim was to minimize antibiotic use by following a standardized protocol in the pre-, peri- and postoperative setting, and adhere to American Urological Association antibiotic guidelines. We hypothesized that prolonged suppressive antibiotics post-urethroplasty does not prevent urinary tract infection and/or wound infection rates.
We prospectively treated 900 patients undergoing urethroplasty or perineal urethrostomy at 11 centers over 2 years. The first-year cohort A received prolonged postoperative antibiotics. Year 2, cohort B, did not receive prolonged antibiotics. A standardized protocol following the American Urological Association guidelines for perioperative antibiotics was used. The 30-day postoperative infectious complications were determined. We used chi-square analysis to compare the cohorts, and multivariate logistic regression to identify risk factors.
The mean age of participants in both cohorts was 49.7 years old and the average stricture length was 4.09 cm. Overall, the rate of postoperative urinary tract infection and wound infection within 30 days was 5.1% (6.7% in phase 1 vs 3.9% in phase 2, p=0.064) and 3.9% (4.1% in phase 1 vs 3.7% in phase 2, p=0.772), respectively. Multivariate logistic regression analysis of patient characteristics and operative factors did not reveal any factors predictive of postoperative infections.
The use of a standardized protocol minimized antibiotic use and demonstrated no benefit to prolonged antibiotic use. There were no identifiable risk factors when considering surgical characteristics. Given the concern of antibiotic over-prescription, we do not recommend prolonged antibiotic use after urethral reconstruction.
Details
- Title: Subtitle
- Minimizing Antibiotic Use in Urethral Reconstruction
- Creators
- Sunchin Kim - University of California San DiegoKatherine C Cheng - University of ArizonaNejd F Alsikafi - Uropartners, Gurnee, Illinois.Benjamin N Breyer - University of California, San FranciscoJoshua A Broghammer - University of Kansas Medical CenterSean P Elliott - University of MinnesotaBradley A Erickson - University of IowaJeremy B Myers - University of UtahThomas G Smith III - Baylor College of MedicineAlex J Vanni - Lahey Hospital and Medical CenterBryan B Voelzke - Spokane Urology, Spokane, Washington.Lee C Zhao - New York UniversityJill C Buckley - University of California San Diego
- Resource Type
- Journal article
- Publication Details
- The Journal of urology, Vol.208(1), pp.128-134
- DOI
- 10.1097/JU.0000000000002487
- PMID
- 35212569
- NLM abbreviation
- J Urol
- ISSN
- 0022-5347
- eISSN
- 1527-3792
- Language
- English
- Date published
- 07/2022
- Academic Unit
- Urology
- Record Identifier
- 9984320860302771
Metrics
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