The Particulars: According to prior analyses, there appears to be considerable variation in the duration and class of antibiotics administered by urologists. This is occurring despite the release of best practice recommendations from the American Urological Association (AUA) for antimicrobial prophylaxis during urologic surgeries. More research is needed to assess compliance with the AUA guidelines for antibiotic class and duration among index urologic procedures.
Data Breakdown: For a study, antibiotic class and duration were obtained from the billing data of patients who underwent one of several types of urologic procedures. The surgeries included radical prostatectomy, radical cystectomy (RC), partial or radical nephrectomy, ureteroscopy or shock wave lithotripsy, transurethral resection of the prostate, percutaneous nephrostolithotomy, transvaginal surgery, penile prosthesis, brachytherapy, or transurethral resection of bladder tumors. Using recommendations from the AUA guidelines, the correct antibiotic class was ordered in 67% of cases, and the correct duration was used in 78% of cases. The average length of antibiotic prophylaxis ranged from 1.1 days after brachytherapy to 10.3 days after RC. Overall compliance with AUA guidelines was 53.4%, but increased over time, rising from 46.2% in 2007 to 58.9% in 2012.
Take Home Pearls: Antibiotic prophylaxis administration in urologic surgeries varies considerably. Although compliance appears to have increased in recent years, efforts are needed to increase the standardization of antibiotic administration for common urologic surgical procedures.