Mp36-06 Validation of Aua Best Practice Guidelines for Prostate Biopsy Infectious Complications and Reducing Variability and Duration of Antimicrobial Utilization: Quality Improvement Initiative
Year: 2016
Type: article
Abstract: You have accessJournal of UrologyInfections/Inflammation/Cystic Disease of the Genitourinary Tract: Prostate & Genitalia II1 Apr 2016MP36-06 VALIDATION OF AUA BEST PRACTICE GUIDELINES FOR PROSTATE BIOPSY INFECTIOUS COMPLICATIONS AND REDUCING VARIABILITY AND DURATION OF ANTIMICROBIAL UTILIZATION: QUALITY IMPROVEMENT INITIATIVE Behfar Ehdaie, Emily Vertosick, Pedro Recabal, Michael Manasia, Mary Schoen, James Eastham, Karim Touijer, and Massimiliano Spaliviero Behfar EhdaieBehfar Ehdaie More articles by this author , Emily VertosickEmily Vertosick More articles by this author , Pedro RecabalPedro Recabal More articles by this author , Michael ManasiaMichael Manasia More articles by this author , Mary SchoenMary Schoen More articles by this author , James EasthamJames Eastham More articles by this author , Karim TouijerKarim Touijer More articles by this author , and Massimiliano SpalivieroMassimiliano Spaliviero More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1640AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The American Urological Association (AUA) recently updated recommendations for antibiotic prophylaxis prior to prostate biopsy. We sought to implement these guidelines to standardize antibiotic prophylaxis in a tertiary health system and assess the impact on infectious complications after biopsy. METHODS Prior to 2013, the choice of prophylactic antibiotics was at the discretion of the surgeon and typically consisted of a 3-day duration. In 2013, we implemented the AUA guidelines to standardize prophylactic antibiotic use. The guidelines describe standardized regimens using a single antibiotic for up to 24 hours duration. The recommendations include consulting the local antibiogram and identifying high-risk men, including recent antibiotic use, and previous biopsy related infection. We enrolled 584 men who underwent biopsy January 2011-January 2012 and 654 men January 2014-January 2015. Men were contacted within 14 days of biopsy, and information was collected prospectively on complications, antibiotics received and bacterial culture results. We calculated the change in overall antibiotic use and rate of infectious complications between men biopsied in 2011 and 2014. RESULTS In 2011, the use of 19 different antibiotic regimens was reported. Antibiotics were usually started the evening before the biopsy, and continued for 72 hours. In 2014, 96% of men received one of 3 standardized antibiotic regimens, which were started on the same day of biopsy and continued for 24-hours. In both 2011 and 2014, fluoroquinolone prophylaxis was the most common regimen. In 2014, 98% of men received a 1 drug regimen, compared to only 73% of men in 2011. Infection rates were low in both cohorts, with 19 men (3.3%) in 2011 and 18 men (2.8%) in 2014. Men treated after implementing a standardized antibiotic regimen had a lower rate of infection (difference -0.5%; 1-sided 95% CI 1.1%). We were able to exclude a clinically relevant increase of > 1.5% in infectious complications using a standardized antibiotic regimen based on AUA guidelines. CONCLUSIONS Implementing the AUA guidelines for antibiotic prophylaxis prior to prostate biopsy decreased the duration of antibiotics from 72 hours to less than 24 hours and the total number of antibiotic regimens from 19 to 3 without observing an increase in infectious complications. We validated the recent AUA guidelines for antibiotic prophylaxis and recommend wide adoption of these guidelines for physicians that perform prostate biopsies. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e491 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Behfar Ehdaie More articles by this author Emily Vertosick More articles by this author Pedro Recabal More articles by this author Michael Manasia More articles by this author Mary Schoen More articles by this author James Eastham More articles by this author Karim Touijer More articles by this author Massimiliano Spaliviero More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
Source: The Journal of Urology
Authors: Behfar Ehdaie, Emily Vertosick, Pedro Recabal, Michael Manasia, Mary Schoen, James Eastham, Karim Touijer, Massimiliano Spaliviero
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2331285205