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Rezaee ME , Towe M , Osman MM , Huynh LM , El-Khatib FM , Andrianne R , Broderick G , Burnett AL , Gross MS , Guise AI , Hatzichristodoulou G , Henry GD , Clavell-Hernandez J , Hsieh TC , Jenkins LC , Lentz A , Munarriz RM , Osmonov D , Park SH , Perito P , Sadeghi-Nejad H , Sempels M , Simhan J , Wang R , Yafi FA
A Multicenter Investigation Examining AUA-Recommended Antibiotic Prophylaxis vs. Non-standard Prophylaxis in Preventing Device Infections in Penile Prosthesis Surgery in Diabetic Patients
J Urol. 2020 Npv;204(5) :969-975
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Abstract
PURPOSE: American Urological Association (AUA) antibiotic prophylaxis recommendations may be insufficient for covering organisms commonly found in penile prosthesis infections. The purpose of this study was to assess the difference between AUA-recommended antibiotic prophylaxis and non-standard prophylaxis in preventing device infections in penile prosthesis surgery performed in diabetics. MATERIALS AND METHODS: A multicenter, retrospective cohort study of diabetic patients undergoing primary penile prosthesis surgery was performed between April 2003 and August 2018. Eighteen institutions from the United States, Europe and Korea contributed. The association between antibiotic prophylaxis type and postoperative penile prosthesis infections, device explantations, and revision surgeries was assessed. RESULTS: Standard AUA antibiotic prophylaxis was followed in 48.6% (n=391) of cases, while non-standard prophylaxis was used in 51.4% (n=413). Common non-standard antibiotic prophylaxis included Vancomycin-Gentamycin- Fluoroquinolone, Clindamycin-Fluoroquinolone, and Vancomycin-Fluoroquinolone among other combinations. Patients who received AUA prophylaxis had significantly more postoperative device infections (5.6% vs. 1.9%, p<0.01) and explantations (8.3% vs. 2.0%, p<0.001) compared to those who received non-standard prophylaxis. Patients who received AUA prophylaxis had significantly higher odds of a postoperative device infection (OR: 2.8, 95% CI 1.1-7.3) and explantation (OR: 3.6, 95% CI 1.4-9.1) compared to those who received non-standard prophylaxis. CONCLUSIONS: Diabetic men with ED who received standard AUA prophylaxis for penile prosthesis surgery had significantly greater odds of experiencing a postoperative device infection and device explantation compared to patients who received non-standard prophylaxis. Our study provides a strong rationale for a prospective investigation to establish the most appropriate prophylaxis strategy in penile prosthesis surgery.
Notes
1527-3792 Rezaee, Michael E Towe, Maxwell Osman, Mohamad M Huynh, Linda M El-Khatib, Farouk M Andrianne, Robert Broderick, Gregory Burnett, Arthur L Gross, Martin S Guise, Amy I Hatzichristodoulou, Georgios Henry, Gerard D Clavell-Hernandez, Jonathan Hsieh, Tung-Chin Jenkins, Lawrence C Lentz, Aaron Munarriz, Ricardo M Osmonov, Daniar Park, Sung Hun Perito, Paul Sadeghi-Nejad, Hossein Sempels, Maxime Simhan, Jay Wang, Run Yafi, Faysal A Journal Article United States J Urol. 2020 Jun 10:101097JU0000000000001158. doi: 10.1097/JU.0000000000001158.