PD53-06 A QUALITY COLLABORATIVE CAN FACILITATE CONSOLIDATION OF ANTIBIOTIC REGIMENS PRIOR TO TRUS PNB– EXPERIENCE FROM THE PENNSYLVANIA UROLOGIC REGIONAL COLLABORATION (PURC) (2019)

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Quality Improvement & Patient Safety III (PD53)1 Apr 2019PD53-06 A QUALITY COLLABORATIVE CAN FACILITATE CONSOLIDATION OF ANTIBIOTIC REGIMENS PRIOR TO TRUS PNB– EXPERIENCE FROM THE PENNSYLVANIA UROLOGIC REGIONAL COLLABORATION (PURC) Adrian Sosenko*, Thomas Lanchoney, Thomas Guzzo, Edouard Trabulsi, John Danella, Mark Mann, Adam Reese, Jeffrey Tomaszewski, Serge Ginzburg, Robert Uzzo, Marc Smaldone, Claudette Fonshell, Bret Marlowe, Jay Raman, and Adrian Sosenko Adrian Sosenko*Adrian Sosenko* More articles by this author , Thomas LanchoneyThomas Lanchoney More articles by this author , Thomas GuzzoThomas Guzzo More articles by this author , Edouard TrabulsiEdouard Trabulsi More articles by this author , John DanellaJohn Danella More articles by this author , Mark MannMark Mann 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 , Marc SmaldoneMarc Smaldone More articles by this author , Claudette FonshellClaudette Fonshell More articles by this author , Bret MarloweBret Marlowe More articles by this author , Jay RamanJay Raman More articles by this author , and Adrian SosenkoAdrian Sosenko More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000556974.85428.c8AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: Transrectal ultrasound guided prostate needle biopsy (TRUS PNB) is associated with infectious complications due to antibiotic resistant organisms. Prophylaxis regimens have evolved to prevent such infections although lack of standardization and heterogeneity may compound this issue further. We review antibiotic prophylaxis practice patterns for TRUS PNB with a focus on the extent of heterogeneity and consolidation of regimens following a physician champion effort. METHODS: The Pennsylvania Urologic Regional Collaboration (PURC) is a physician-led quality collaborative established in 2015 with 9 participating practices encompassing 108 urologists. Amongst biopsies performed from 2015-2017, 5379 had documentation of prophylactic antibiotic regimen and formed the cohort of analysis. Overall number and distribution of antibiotic regimens were determined. Quarterly trends in the number of unique antibiotic regimens were noted. RESULTS: Of the 5379 TRUS PNB cases, 4147 (77%) utilized a single agent, 1197 (22%) used dual augmented therapy, and 35(1%) incorporated three or more antibiotics for prophylaxis. To date, 88 unique antibiotic regimens were used for prophylaxis with the 10 most common noted in Figure 1. Ciprofloxacin (n=2609, 48%) and Ceftriaxone (n=2268, 42%) were most often used either alone or in combination with other agents. The number of unique antibiotic combinations increased quarterly from Q2 2015 (n=18 regimens) to Q2 2017 (n=40 regimens). A physician champion led effort to standardize regimens based on guidelines and local antibiograms resulted in a 43% reduction in unique regimens (Q4 2017; n=23 regimens). (Figure 2) CONCLUSIONS: Significant variability exists with respect to prophylactic antibiotic regimens across providers in PURC. However, proactive guidelines based education was successful in consolidating protocols. Future evaluation is requisite to determine sustainability of such efforts. Source of Funding: none Hershey, PA; Philadelphia, PA; Heshey, PA; Philadelphia, PA; Hershey, PA; Philadelphia, PA; Hershey, PA© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e932-e932 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Adrian Sosenko* More articles by this author Thomas Lanchoney More articles by this author Thomas Guzzo More articles by this author Edouard Trabulsi More articles by this author John Danella More articles by this author Mark Mann 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 Marc Smaldone More articles by this author Claudette Fonshell More articles by this author Bret Marlowe More articles by this author Jay Raman More articles by this author Adrian Sosenko More articles by this author Expand All Advertisement PDF downloadLoading ...