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Does Antimicrobial Prophylaxis in Patients with Specific Comorbidities Reduce the Risk of Infection after Simple Cystourethroscopy?

2022; Lippincott Williams & Wilkins; Volume: 9; Issue: 5 Linguagem: Inglês

10.1097/upj.0000000000000325

2352-0787

Brenton Sherwood, Elizabeth Takacs, Bradley Ford, Sarah L. Mott, Bradley T. Loeffler, Gina Lockwood,

Bladder and Urothelial Cancer Treatments

No AccessUrology PracticeHealth Policy1 Sep 2022Does Antimicrobial Prophylaxis in Patients with Specific Comorbidities Reduce the Risk of Infection after Simple Cystourethroscopy?This article is commented on by the following:Editorial CommentaryEditorial CommentaryEditorial Commentary Brenton G. Sherwood, Elizabeth B. Takacs, Bradley A. Ford, Sarah L. Mott, Bradley T. Loeffler, and Gina M. Lockwood Brenton G. SherwoodBrenton G. Sherwood *Correspondence: Department of Urology, University of Iowa Hospitals and Clinics, 200 Hawkins Dr., 3 RCP, Iowa City, Iowa 52242-1089 telephone: 319-899-1470; FAX: 319-356-3900; email address: E-mail Address: [email protected] Department of Urology, University of Iowa Hospitals and Clinics, Iowa City, Iowa More articles by this author , Elizabeth B. TakacsElizabeth B. Takacs Department of Urology, University of Iowa Hospitals and Clinics, Iowa City, Iowa More articles by this author , Bradley A. FordBradley A. Ford Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, Iowa More articles by this author , Sarah L. MottSarah L. Mott Holden Comprehensive Cancer Center, University of Iowa Hospitals and Clinics, Iowa City, Iowa More articles by this author , Bradley T. LoefflerBradley T. Loeffler Holden Comprehensive Cancer Center, University of Iowa Hospitals and Clinics, Iowa City, Iowa More articles by this author , and Gina M. LockwoodGina M. Lockwood Department of Urology, University of Iowa Hospitals and Clinics, Iowa City, Iowa More articles by this author View All Author Informationhttps://doi.org/10.1097/UPJ.0000000000000325AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Introduction: We evaluated whether antimicrobial prophylaxis decreases rates of post-procedural infection (urinary tract infection or sepsis) after simple cystourethroscopy for patients with specific comorbidities. Methods: We utilized Epic® reporting software to conduct a retrospective review of all simple cystourethroscopy procedures performed by providers in our urology department from August 4, 2014 to December 31, 2019. Data collected included patient comorbidities, antimicrobial prophylaxis administration and incidence of post-procedural infection. Mixed effects logistic regression models were utilized to estimate the effects of antimicrobial prophylaxis and patient comorbidities on the odds of post-procedural infection. Results: Antimicrobial prophylaxis was given for 7,001 (78%) of 8,997 simple cystourethroscopy procedures. Overall, 83 (0.9%) post-procedural infections occurred. The estimated odds of post-procedural infection were lower when antimicrobial prophylaxis was given compared to those without prophylaxis (OR 0.51, 95% CI 0.35–0.76; p <0.01). The number needed to treat with antimicrobial prophylaxis to prevent 1 post-procedural infection was 100. None of the comorbidities evaluated showed significant benefit from antimicrobial prophylaxis for prevention of post-procedural infection. Conclusions: Overall, the rate of post-procedural infection after simple office cystourethroscopy was low (0.9%). Though antimicrobial prophylaxis decreased the odds of post-procedural infection overall, the number needed to treat was high (100). Antibiotic prophylaxis was not shown to significantly reduce the risk of post-procedural infection in any of the comorbidity groups we evaluated. These findings suggest that the comorbidities evaluated in this study should not be used to recommend antibiotic prophylaxis for simple cystourethroscopy. References 1. : Antibiotic prophylaxis for transurethral urological surgeries: systematic review. Urol Ann 2013; 5: 61. Google Scholar 2. : An evidence-based protocol for antibiotic use prior to cystoscopy decreases antibiotic use without impacting post-procedural symptomatic urinary tract infection rates. J Urol 2018; 199: 1004. Link, Google Scholar 3. : Best practice statement on urologic procedures and antimicrobial prophylaxis. J Urol 2020; 203: 351. 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Google Scholar Submitted March 20, 2022; accepted May 19, 2022; published July 4, 2022. Support: National Institutes of Health (BL). Conflict of Interest: Elizabeth Takacs: Medtronic: participation in research trial—payment for travel expenses and time related to training; NCS of the AUA North Central Section: secretary, member of Board of Directors—reimbursement for travel expenses for meeting, meals and lodging; Ohio Urologic Society—paid lecturer for state society meeting. The remaining Authors have no conflicts of interest to disclose. Ethics Statement: This study received Institutional Review Board Approval (IRB no. 201404766). © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byHerr H (2022) Does Antimicrobial Prophylaxis in Patients With Specific Comorbidities Reduce the Risk of Infection After Simple Cystourethroscopy? Letter.Urology Practice, VOL. 10, NO. 1, (1-1), Online publication date: 1-Jan-2023.Related articlesUrology Practice4 Jul 2022Editorial CommentaryUrology Practice4 Jul 2022Editorial CommentaryUrology Practice4 Jul 2022Editorial Commentary Volume 9Issue 5September 2022Page: 414-422 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.Keywordsantibiotic prophylaxiscystoscopyurinary tract infectionsrisk factorsantimicrobial stewardshipMetricsAuthor Information Brenton G. Sherwood Department of Urology, University of Iowa Hospitals and Clinics, Iowa City, Iowa *Correspondence: Department of Urology, University of Iowa Hospitals and Clinics, 200 Hawkins Dr., 3 RCP, Iowa City, Iowa 52242-1089 telephone: 319-899-1470; FAX: 319-356-3900; email address: E-mail Address: [email protected] More articles by this author Elizabeth B. Takacs Department of Urology, University of Iowa Hospitals and Clinics, Iowa City, Iowa More articles by this author Bradley A. Ford Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, Iowa More articles by this author Sarah L. Mott Holden Comprehensive Cancer Center, University of Iowa Hospitals and Clinics, Iowa City, Iowa More articles by this author Bradley T. Loeffler Holden Comprehensive Cancer Center, University of Iowa Hospitals and Clinics, Iowa City, Iowa More articles by this author Gina M. Lockwood Department of Urology, University of Iowa Hospitals and Clinics, Iowa City, Iowa More articles by this author Expand All Submitted March 20, 2022; accepted May 19, 2022; published July 4, 2022. Support: National Institutes of Health (BL). Conflict of Interest: Elizabeth Takacs: Medtronic: participation in research trial—payment for travel expenses and time related to training; NCS of the AUA North Central Section: secretary, member of Board of Directors—reimbursement for travel expenses for meeting, meals and lodging; Ohio Urologic Society—paid lecturer for state society meeting. The remaining Authors have no conflicts of interest to disclose. Ethics Statement: This study received Institutional Review Board Approval (IRB no. 201404766). Advertisement PDF downloadLoading ...