Trends over 20 years of antimicrobial prophylaxis for artificial urinary sphincter surgery.
antibiotics
artificial urinary sphincter
guidelines
prophylaxis
Journal
Neurourology and urodynamics
ISSN: 1520-6777
Titre abrégé: Neurourol Urodyn
Pays: United States
ID NLM: 8303326
Informations de publication
Date de publication:
08 2023
08 2023
Historique:
revised:
27
03
2023
received:
05
01
2023
accepted:
08
05
2023
medline:
31
7
2023
pubmed:
20
5
2023
entrez:
20
5
2023
Statut:
ppublish
Résumé
Perioperative antimicrobial prophylaxis is crucial for prevention of prosthesis and patient morbidity after artificial urinary sphincter (AUS) placement. While antibiotic guidelines exist for many urologic procedures, adoption patterns for AUS surgery are unclear. We aimed to assess trends in antibiotic prophylaxis for AUS and outcomes relative to American Urological Association (AUA) Best Practice guidelines. The Premier Healthcare Database was queried from 2000 to 2020. Encounters involving AUS insertion, revision/removal, and associated complications were identified via ICD and CPT codes. Premier charge codes were used to identify antibiotics used during the insertion encounter. AUS-related complication events were found using patient hospital identifiers. Univariable analysis between hospital/patient characteristics and use of guideline-adherent antibiotics was done via chi-squared and Kruskal-Wallis tests. A multivariable logistic mixed effects model was used to assess factors related to the odds of complication, specifically the use of guideline-adherent versus nonadherent regimens. Of 9775 patients with primary AUS surgery, 4310 (44.1%) received guideline-adherent antibiotics. The odds of guideline-adherent regimen use increased 7.7% per year with 53.0% (830/1565) receiving guideline-adherent antibiotics by the end of the study period. Patients with guideline-adherent regimens had a decreased risk of any complication (odds ratio [OR]: 0.83, 95% confidence interval [CI]: 0.74-0.93) and surgical revision (OR: 0.85, 95% CI: 0.74-0.96) within 3 months; however, no significant difference in infection within was noted (OR: 0.89, 95% CI: 0.68-1.17) within 3 months. Adherence to AUA antimicrobial guidelines for AUS surgery appears to have increased over the last two decades. While guideline-adherent regimens were associated with decreased risk of any complication and surgical intervention, no significant association was found with risk of infection. Surgeons appear to be increasingly following AUA recommendations for antimicrobial prophylaxis for AUS surgery, however, further level 1 evidence should be obtained to demonstrate conclusive benefit of these regimens.
Substances chimiques
Anti-Bacterial Agents
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1421-1430Informations de copyright
© 2023 The Authors. Neurourology and Urodynamics published by Wiley Periodicals LLC.
Références
Koch GE, Kaufman MR. Male stress urinary incontinence. Urol Clin North Am. 2022;49(3):403-418. doi:10.1016/j.ucl.2022.04.005
Hester AG, Kretschmer A, Badlani G. Male incontinence: the etiology or basis of treatment. Eur Urol Focus. 2017;3(4-5):377-384. doi:10.1016/j.euf.2017.12.002
Srivastava A, Joice GA, Patel HD, Manka MG, Sopko NA, Wright EJ. Causes of artificial urinary sphincter failure and strategies for surgical revision: implications of device component survival. Eur Urol Focus. 2019;5(5):887-893. doi:10.1016/j.euf.2018.02.014
Suarez OA, McCammon KA. The artificial urinary sphincter in the management of incontinence. Urology. 2016;92:14-19. doi:10.1016/j.urology.2016.01.016
Shelton TM, Brimley S, Tsambarlis P, Hellstrom WJG. Current perspectives on complications of surgical treatments for male stress urinary incontinence. Sexual Med Rev. 2020;8(3):443-449. doi:10.1016/j.sxmr.2019.12.003
Linder BJ, de Cogain M, Elliott DS. Long-term device outcomes of artificial urinary sphincter reimplantation following prior explantation for erosion or infection. J Urol. 2014;191(3):734-738. doi:10.1016/j.juro.2013.08.089
Hofer MD, Gonzalez CM. Current concepts in infections associated with penile prostheses and artificial sphincters. Urol Clin North Am. 2015;42(4):485-492. doi:10.1016/j.ucl.2015.05.008
Lai HH, Boone TB. Complex artificial urinary sphincter revision and reimplantation cases-How do they fare compared to virgin cases? J Urol. 2012;187(3):951-955. doi:10.1016/j.juro.2011.10.153
Wolf JS, Bennett CJ, Dmochowski RR, Hollenbeck BK, Pearle MS, Schaeffer AJ. Best practice policy statement on urologic surgery antimicrobial prophylaxis. J Urol. 2008;179(4):1379-1390. doi:10.1016/j.juro.2008.01.068
Lightner DJ, Wymer K, Sanchez J, Kavoussi L. Best practice statement on urologic procedures and antimicrobial prophylaxis. J Urol. 2020;203(2):351-356. doi:10.1097/JU.0000000000000509
Rezaee ME, Towe M, Osman MM, et al. A multicenter investigation examining American Urological Association recommended antibiotic prophylaxis vs nonstandard prophylaxis in preventing device infections in penile prosthesis surgery in diabetic patients. J Urol. 2020;204(5):969-975. doi:10.1097/JU.0000000000001158
Swanton AR, Yafi FA, Munarriz RM, Gross MS. A critique of the American Urological Association penile prosthesis antibiotic prophylaxis guidelines. J Sex Med. 2021;18(1):1-3. doi:10.1016/j.jsxm.2020.10.010
PINC AITM Healthcare Data: Data That Informs and Performs (White Paper). PINC AITM Applied Sciences, Premier Inc.; 2022:13.
Higgins TL, Deshpande A, Zilberberg MD, et al. Assessment of the accuracy of using ICD-9 diagnosis codes to identify pneumonia etiology in patients hospitalized with pneumonia. JAMA Netw Open. 2020;3(7):e207750. doi:10.1001/jamanetworkopen.2020.7750
Bates D, Mächler M, Bolker B, Walker S. Fitting Linear Mixed-Effects Models using lme4; 2014. doi:10.48550/ARXIV.1406.5823
Yafi FA, DeLay KJ, Stewart C, Chiang J, Sangkum P, Hellstrom WJG. Device survival after primary implantation of an artificial urinary sphincter for male stress urinary incontinence. J Urol. 2017;197(3 pt 1):759-765. doi:10.1016/j.juro.2016.08.107
Van der Aa F, Drake MJ, Kasyan GR, Petrolekas A, Cornu JN. The artificial urinary sphincter after a quarter of a century: a critical systematic review of its use in male non-neurogenic incontinence. Eur Urol. 2013;63(4):681-689. doi:10.1016/j.eururo.2012.11.034
O'Connor RC, Nanigian DK, Patel BN, Guralnick ML, Ellision LM, Stone AR. Artificial urinary sphincter placement in elderly men. Urology. 2007;69(1):126-128. doi:10.1016/j.urology.2006.09.021
Ballantyne CC, Sharma D, Rapp DE, Boatman KR, Krzastek SC, Costabile RA. Prevalence of cognitive impairment and sphincter misuse among men with artificial urinary sphincters. Urology. 2021;148:292-296. doi:10.1016/j.urology.2020.10.021
Dropkin BM, Sanders SC, Kavoussi M, et al. Same day discharge versus overnight observation protocols-similar outcomes following artificial urinary sphincter surgery. Urology. 2021;157:206-210. doi:10.1016/j.urology.2021.08.016
Magera JS, Inman BA, Elliott DS. Does preoperative topical antimicrobial scrub reduce positive surgical site culture rates in men undergoing artificial urinary sphincter placement. J Urol. 2007;178(4):1328-1332. doi:10.1016/j.juro.2007.05.146
Biardeau X, Aharony S, the AUS Consensus Group, Campeau L, Campeau L, Corcos J. Artificial urinary sphincter: report of the 2015 consensus conference: artificial urinary sphincter. Neurourol Urodyn. 2016;35(S2):S8-S24. doi:10.1002/nau.22989
Cai T, Verze P, Brugnolli A, et al. Adherence to European Association of Urology guidelines on prophylactic antibiotics: an important step in antimicrobial stewardship. Eur Urol. 2016;69(2):276-283. doi:10.1016/j.eururo.2015.05.010
Bell BG, Schellevis F, Stobberingh E, Goossens H, Pringle M. A systematic review and meta-analysis of the effects of antibiotic consumption on antibiotic resistance. BMC Infect Dis. 2014;14(1):13. doi:10.1186/1471-2334-14-13
Gross MS, Reinstatler L, Henry GD, et al. Multicenter investigation of fungal infections of inflatable penile prostheses. J Sex Med. 2019;16(7):1100-1105. doi:10.1016/j.jsxm.2019.05.003
Towe M, Andrianne R, Broderick G, et al. 028 adherence to the AUA penile prosthesis antibiotic prophylaxis guidelines in diabetic patients is associated with significantly higher risks of device infection. J Sex Med. 2020;17(suppl 1):S15. doi:10.1016/j.jsxm.2019.11.030
Bonkat G, Pickard R, Bartoletti R, et al. Urological Infections. European Association of Urology; 2018.
Bader MS, Loeb M, Leto D, Brooks AA. Treatment of urinary tract infections in the era of antimicrobial resistance and new antimicrobial agents. Postgrad Med. 2020;132(3):234-250. doi:10.1080/00325481.2019.1680052
Poulikakos P, Falagas ME. Aminoglycoside therapy in infectious diseases. Expert Opin Pharmacother. 2013;14(12):1585-1597. doi:10.1517/14656566.2013.806486
Tanne JH. FDA adds "black box" warning label to fluoroquinolone antibiotics. BMJ. 2008;337(a816):a816. doi:10.1136/bmj.a816