INTRODUCTION: Penile prosthesis @entity281 remain challenging despite advancements in surgical technique, device improvements, and adoption of antibiotic prophylaxis guidelines. AIM: To investigate penile prosthesis @entity281 microbiology to consider which changes in practice could decrease @entity281 rates, to evaluate current antibiotic prophylaxis guidelines, and to develop a proposed algorithm for @entity546 . METHODS: This retrospective institutional review board-exempt multi-institutional study from 25 centers reviewed intraoperative cultures obtained at explantation or Mulcahy salvage of infected three-piece inflatable penile prostheses (IPPs). Antibiotic usage was recorded at implantation, admission for @entity281 , and explantation or salvage surgery. Cultures were obtained from purulent material in the implant space and from the biofilm on the device. MAIN OUTCOME MEASURES: Intraoperative culture data from infected IPPs. RESULTS: Two hundred twenty-seven intraoperative cultures (2002-2016) were obtained at salvage or explantation. No culture growth occurred in 33% of cases and gram-positive and gram-negative organisms were found in 73% and 39% of positive cultures, respectively. Candida species (11.1%), anaerobes (10.5%) and @entity3256 -resistant @entity794 (9.2%) constituted nearly one third of 153 positive cultures. Multi-organism @entity281 occurred in 25% of positive cultures. Antibiotic regimens at initial implantation were generally consistent with American Urological Association (AUA) and European Association of Urology (EAU) guidelines. However, the micro-organisms identified in this study were covered by these guidelines in only 62% to 86% of cases. Antibiotic selection at admissions for @entity281 and salvage or explantation varied widely compared with those at IPP implantation. CONCLUSION: This study documents a high incidence of anaerobic, Candida, and @entity3256 -resistant @entity16330 @entity281 . In addition, approximately one third of @entity546 cases had negative cultures. Micro-organisms identified in this study were not covered by the AUA and EAU antibiotic guidelines in at least 14% to 38% of cases. These findings suggest broadening antibiotic prophylaxis guidelines and creating a management algorithm for IPP @entity281 might lower @entity281 rates and improve salvage success. Gross MS, Phillips EA, Carrasquillo RJ, et  al. Multicenter Investigation of the Micro-Organisms Involved in @entity546 : An Analysis of the Efficacy of the AUA and EAU Guidelines for Penile Prosthesis Prophylaxis. J Sex Med 2017;XX:XXX-XXX.

Multicenter Investigation of the Micro-Organisms Involved in XXXX : An Analysis of the Efficacy of the AUA and EAU Guidelines for Penile Prosthesis Prophylaxis.

@entity3256 :: ('MESH:D008712', 'Chemical') :: ['methicillin'] @entity794 :: ('1280', 'Species') :: ['Staphylococcus aureus'] @entity281 :: ('MESH:D007239', 'Disease') :: ['infection', 'infections'] @entity546 :: ('MESH:D004414', 'Disease') :: ['infected penile prosthesis', 'penile prosthesis infections', 'Penile Prosthesis Infection'] @entity16330 :: ('78380', 'Species') :: ['S aureus']
@entity546 :: (MESH:D004414,Disease) :: ['Penile Prosthesis Infection']
