MP51-18 PRACTICE PATTERNS OF PROSTATE BIOPSY ANTIBIOTIC PROPHYLAXIS IN OVER 4000 PATIENTS FROM THE PENNSYLVANIA UROLOGIC REGIONAL COLLABORATION (PURC) (2018)

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Practice Patterns, Quality of Life & Shared Decision Making II1 Apr 2018MP51-18 PRACTICE PATTERNS OF PROSTATE BIOPSY ANTIBIOTIC PROPHYLAXIS IN OVER 4000 PATIENTS FROM THE PENNSYLVANIA UROLOGIC REGIONAL COLLABORATION (PURC) Jay D. Raman, Marc Smaldone, Thomas Guzzo, John Danella, Edouard Trabulsi, Adam Reese, Jeffrey Tomaszewski, Serge Ginzburg, Robert Uzzo, Claudette Fonshell, Bret Marlowe, and Thomas Lanchoney Jay D. RamanJay D. Raman More articles by this author , Marc SmaldoneMarc Smaldone More articles by this author , Thomas GuzzoThomas Guzzo More articles by this author , John DanellaJohn Danella More articles by this author , Edouard TrabulsiEdouard Trabulsi More articles by this author , Adam ReeseAdam Reese More articles by this author , Jeffrey TomaszewskiJeffrey Tomaszewski More articles by this author , Serge GinzburgSerge Ginzburg More articles by this author , Robert UzzoRobert Uzzo More articles by this author , Claudette FonshellClaudette Fonshell More articles by this author , Bret MarloweBret Marlowe More articles by this author , and Thomas LanchoneyThomas Lanchoney More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1649AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Prostate needle biopsy (PNB) is the referent standard for establishing the histologic diagnosis of prostate cancer. Several white papers and best practice statements from the American Urologic Association (AUA) have addressed elements of the PNB procedure. The extent to which such publications have standardized practice patterns remains unclear. Therefore, we review practice patterns pertaining to PNB in a large statewide quality registry with a focus on the extent of heterogeneity across practices and providers. METHODS The Pennsylvania Urologic Regional Collaboration (PURC) is a physician-led statewide quality collaborative focusing on prostate cancer diagnosis and therapy. Established in 2015, 9 participating practices encompassing 88 physicians have accrued over 5,600 patients into this data registry. Amongst these patients, 4175 (74%) had a PNB performed at one of the practices and formed the cohort of interest. SAS version 9.4 was used for analysis. RESULTS 4175 men underwent a transrectal ultrasound or fusion guided biopsy of which 82% were an initial biopsy, 13% had one prior biopsy, and 5% had multiple prior biopsies. Antimicrobial prophylaxis was prescribed in 97% of cases with 92% of men having documentation of receipt prior to the time of biopsy. Antibiotic regimen strategies included single agent in 76% of cases, dual agent augmented treatment in 21%, and triple antibiotic prophylaxis in 3%. The most common prophylaxis regimen was single agent Ciprofloxacin (41%) or Ceftriaxone (26%) with an amalgam of different combinations thereafter. (Figure) Rectal cultures with targeted antibiotics was infrequently incorporated into practice (<1% of cases). Infectious complications including fever, documented UTI, or urinary sepsis were documented in 31 patients (0.86%). No specific antibiotic regimen was associated with infections (p>0.05 for all) CONCLUSIONS Reported infection rates following PNB in this large registry is low (˜1%). Nonetheless, significant practice pattern variability exists across providers with regards to procedural antibiotic prophylaxis. Efforts at standardization with published AUA recommendations continues albeit with understanding some inherent variability exists based on local antibiograms. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e692 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Jay D. Raman More articles by this author Marc Smaldone More articles by this author Thomas Guzzo More articles by this author John Danella More articles by this author Edouard Trabulsi More articles by this author Adam Reese More articles by this author Jeffrey Tomaszewski More articles by this author Serge Ginzburg More articles by this author Robert Uzzo More articles by this author Claudette Fonshell More articles by this author Bret Marlowe More articles by this author Thomas Lanchoney More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...