MP20-14 ANTIMICROBIAL UTILIZATION PRIOR TO ENDOUROLOGICAL SURGERY FOR UROLITHIASIS: ENDOUROLOGICAL SOCIETY SURVEY RESULTS (2015)

You have accessJournal of UrologyInfections/Inflammation of the Genitourinary Tract: Kidney & Bladder II1 Apr 2015MP20-14 ANTIMICROBIAL UTILIZATION PRIOR TO ENDOUROLOGICAL SURGERY FOR UROLITHIASIS: ENDOUROLOGICAL SOCIETY SURVEY RESULTS Adam Kaplan, Ramy Yacoub, Richard Shin, Fernando Cabrera, Andreas Neisius, Charles Scales, Roger Sur, Anicka Ackerman, Michael Ferrandino, Brian Eisner, Glenn Preminger, and Michael Lipkin Adam KaplanAdam Kaplan More articles by this author , Ramy YacoubRamy Yacoub More articles by this author , Richard ShinRichard Shin More articles by this author , Fernando CabreraFernando Cabrera More articles by this author , Andreas NeisiusAndreas Neisius More articles by this author , Charles ScalesCharles Scales More articles by this author , Roger SurRoger Sur More articles by this author , Anicka AckermanAnicka Ackerman More articles by this author , Michael FerrandinoMichael Ferrandino More articles by this author , Brian EisnerBrian Eisner More articles by this author , Glenn PremingerGlenn Preminger More articles by this author , and Michael LipkinMichael Lipkin More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.986AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Guidelines and practice patterns regarding the use of antibiotic prophylaxis for endourologic stone surgery vary considerably. Our objective herein was to quantify the variations of antibiotic usage worldwide. METHODS An online survey was distributed to members of the Endourologic Society. The survey used case scenarios to query the respondents' proposed duration of antimicrobial therapy prior to uncomplicated ureteroscopy (URS) and percutaneous nephrolithotomy (PNL). Case scenarios include pre-operative cultures that were either negative or positive without symptoms of urinary tract infection. RESULTS The response rate was 18.5% with 369 responders (40% from U.S., 61% academic and 64% endourology fellowship trained). The majority of respondents reported giving a single perioperative dose in patients with a negative urine culture (71% and 59% prior to URS and PNL; respectively). In patients with positive cultures, the responses were more heterogeneous. In the presence of a positive culture prior to URS the results were as follows: 13% preferred a single perioperative dose, 29% preferred 1–3 days, 46% preferred 4–7 days and 12% preferred > 7 days of antibiotics before the procedure. In presence of positive culture prior to PNL, 11% preferred single perioperative dose, 24% preferred 1–3 days, 49% preferred 4–7 days and 16 % preferred > 7 days. CONCLUSIONS There are considerable variations in antimicrobial utilization prior to endourologic surgery for urolithiasis worldwide. According to current guidelines, nearly 1/3 of urologists are over-utilizing antibiotics prior to stone management in patients with negative cultures. Well-designed prospective randomized studies are needed to guide appropriate duration of prophlyactic antibiotics in patients with positive cultures. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e228 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Adam Kaplan More articles by this author Ramy Yacoub More articles by this author Richard Shin More articles by this author Fernando Cabrera More articles by this author Andreas Neisius More articles by this author Charles Scales More articles by this author Roger Sur More articles by this author Anicka Ackerman More articles by this author Michael Ferrandino More articles by this author Brian Eisner More articles by this author Glenn Preminger More articles by this author Michael Lipkin More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...