Assessing peri-operative antibiotic administration practices amongst urologic surgeons performing holmium laser enucleation of the prostate worldwide.

IF 2.8 2区 医学 Q2 UROLOGY & NEPHROLOGY
Seyed Mohammad Mohaghegh Poor, Hafsa Asif, Darion Denis-Diaz, Eric Riedinger, Tasha Posid, Maxwell Newton, Michael Sourial, Mark Assmus, Amy Krambeck, Bodo Knudsen, Matthew Lee
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Abstract

Purpose: Holmium Laser Enucleation of the Prostate (HoLEP) is a size-independent surgical treatment for benign prostatic hypertrophy. There is currently a lack of data on peri-operative antibiotic prescribing patterns for HoLEP and, thus, no consensus on optimal practices. This study aims to assess peri-operative antibiotic prescribing practices for HoLEP.

Methods: Members of the Endourological Society (EUS) were invited by e-mail to complete a REDCap survey. The survey inquired about surgeons' practice setting, training, surgical volume, antibiotic prescribing practices and explored different factors that might affect antibiotic choice and duration. A p-value of < 0.05 was determined to be statistically significant.

Results: A total of 70 Urologists (66 male, 4 female) reported that they performed an average of 108 HoLEPs per year with a mean clinical experience of 11 years. In the case of a negative pre-operative urine culture with a patient who is not catheterized/intermittently self-catheterizing (C/ISC), 96% of urologists would only give a single peri-operative dose of antibiotic. If the patient is C/ISC then 49% of Urologists would give more than a single dose of peri-operative antibiotic when the urine culture is negative. If the pre-operative urine culture is negative, 39% of surgeons would prescribe post-operative antibiotics even when the patient is not C/ISC and this increased to 64% if the patient is C/ISC. The most common factors urologists considered when prescribing antibiotic prophylaxis/therapy were positive urine culture, catheterization status, and a history of recurrent UTIs. Non-academic urologists administered post-operative prophylaxis more often (p < 0.05) and urologists with more experience treated a positive urine culture for a shorter period.

Conclusion: There is significant variability for peri-operative antibiotic prescribing practices prior to HoLEP. In general, more antibiotics are prescribed if the patient has a history of C/ISC or infection. Further clinical studies are needed to identify optimal antibiotic prescribing protocols prior to HoLEP.

目的:前列腺钬激光去核术(HoLEP)是一种与体型无关的良性前列腺肥大手术治疗方法。目前缺乏有关 HoLEP 围手术期抗生素处方模式的数据,因此也未就最佳做法达成共识。本研究旨在评估 HoLEP 的围手术期抗生素处方:方法:通过电子邮件邀请内瘘协会(EUS)成员完成 REDCap 调查。调查询问了外科医生的执业环境、培训、手术量、抗生素处方实践,并探讨了可能影响抗生素选择和持续时间的不同因素。结果显示共有 70 名泌尿科医生(66 名男性,4 名女性)表示,他们每年平均进行 108 例泌尿系结石手术,平均临床经验为 11 年。如果患者术前尿培养呈阴性,且未使用导尿管/间歇性自导尿(C/ISC),96% 的泌尿科医生仅会在围手术期使用一剂抗生素。如果患者是 C/ISC 患者,那么 49% 的泌尿科医生会在尿培养阴性的情况下,在围手术期给予多于一剂的抗生素。如果术前尿培养呈阴性,即使患者不是 C/ISC 也有 39% 的外科医生会在术后处方抗生素,而如果患者是 C/ISC 则会增加到 64%。泌尿科医生在开具抗生素预防/治疗处方时最常考虑的因素是尿液培养阳性、导尿状况和复发性尿道炎病史。非学术型泌尿科医生更常进行术后预防治疗(P 结论:非学术型泌尿科医生更常进行术后预防治疗:HoLEP术前的围手术期抗生素处方存在很大差异。一般来说,如果患者有 C/ISC 或感染病史,则会处方更多抗生素。需要进一步开展临床研究,以确定 HoLEP 术前最佳抗生素处方方案。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
World Journal of Urology
World Journal of Urology 医学-泌尿学与肾脏学
CiteScore
6.80
自引率
8.80%
发文量
317
审稿时长
4-8 weeks
期刊介绍: The WORLD JOURNAL OF UROLOGY conveys regularly the essential results of urological research and their practical and clinical relevance to a broad audience of urologists in research and clinical practice. In order to guarantee a balanced program, articles are published to reflect the developments in all fields of urology on an internationally advanced level. Each issue treats a main topic in review articles of invited international experts. Free papers are unrelated articles to the main topic.
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