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Are postoperative antibiotics necessary after artificial urinary sphincter insertion?
Dropkin, Benjamin M; Dallmer, Jeremiah D; Chisholm, Leah P; Johnsen, Niels V; Dmochowski, Roger R; Milam, Douglas F; Kaufman, Melissa R.
Afiliación
  • Dropkin BM; Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Can J Urol ; 27(6): 10437-10442, 2020 12.
Article en En | MEDLINE | ID: mdl-33325344
INTRODUCTION We sought to explore whether patients discharged without antibiotics after artificial urinary sphincter (AUS) insertion were more likely to require device explantation for infection or erosion compared to patients discharged with antibiotics at our institution and compared to patients in other large, contemporary series. MATERIALS AND METHODS: AUS insertions performed at our institution between 2013 and 2017 were retrospectively reviewed to determine demographics, comorbidities, and perioperative and medium-term outcomes. Patients were grouped based on 1) known risk factors for infectious complications or erosion and 2) postoperative antibiotic prescription status. Patients were placed in Group 1 if they did not demonstrate risk factors and did not receive postoperative antibiotics, Group 2 if they did possess risk factors but did not receive postoperative antibiotics, and Group 3 if they had risk factors and received postoperative antibiotics. RESULTS: Of the 155 men who met inclusion criteria, 44, 47, and 64 were categorized in Groups 1, 2, and 3, respectively. Median (IQR) follow up was similar across Groups 1, 2, and 3 (12.7 [4.6-25.1] versus 10.7 [4.5-31.3] versus 8.3 [4.4-26.4] months, p = 0.808). Rates of explantation due to device infection (0 versus 2 versus 6%, p = 0.172) or cuff erosion (2 versus 2 versus 8%, p = 0.253) did not vary significantly between Groups 1-3. CONCLUSIONS: Patients undergoing AUS insertion may be unlikely to benefit from the routine administration of postoperative antibiotics. In light of the known consequences of antibiotic overuse, a randomized controlled trial is warranted.
Asunto(s)
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Esfínter Urinario Artificial / Infecciones Relacionadas con Prótesis / Implantación de Prótesis / Antibacterianos Tipo de estudio: Etiology_studies / Observational_studies / Risk_factors_studies Límite: Aged / Aged80 / Humans / Male / Middle aged Idioma: En Revista: Can J Urol Asunto de la revista: UROLOGIA Año: 2020 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Canadá
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Esfínter Urinario Artificial / Infecciones Relacionadas con Prótesis / Implantación de Prótesis / Antibacterianos Tipo de estudio: Etiology_studies / Observational_studies / Risk_factors_studies Límite: Aged / Aged80 / Humans / Male / Middle aged Idioma: En Revista: Can J Urol Asunto de la revista: UROLOGIA Año: 2020 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Canadá