Penile Prosthesis Insertion in the Era of Antibiotic Stewardship—Are Postoperative Antibiotics Necessary?

Dropkin, Benjamin M.; Chisholm, Leah; Dallmer, Jeremiah; Johnsen, Niels V.; Dmochowski, Roger R.; Milam, Douglas F.; Kaufman, Melissa R.

doi:10.1097/ju.0000000000000578

Cited by 15 publications

(8 citation statements)

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“…In this retrospective review Dropkin et al (page 611) from Nashville, Tennessee evaluated patients grouped into 3 different risk categories with postoperative antibiotics used only in those with significant risk factors for infection. 7 Rates of explantation and nonoperative infectious complications did not vary among groups which seems to validate the best practice statement recommendation.…”

Section: Antibiotics For Penile Prosthesis Insertionmentioning

confidence: 56%

This Month in Adult Urology

Smith¹

2020

Journal of Urology

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Patients should be involved in treatment decisions but it is often difficult for them to make an informed choice. Recognized experts may disagree, information on the internet can be suspect and physicians often incompletely suppress their own biases. Nowhere is this more true than in treatment of prostate cancer. Once a patient has decided on surgery, there are different surgical approaches to consider. A patient may come to regret a decision, especially if the outcome is different than expected.Baunacke et al (page 554) from Germany evaluated decision regret after radical prostatectomy in a cohort of 1,260 patients, and overall decision regret was low. 1 Erectile function, urinary continence and freedom from recurrence correlated with regret but surgical approach did not. An active role in decision making led to lower regret. The surgeon plays a highly influential role in informed consent and patients should be intimately involved in the process. A well informed patient is less likely to regret a decision even if things do not turn out completely as expected.

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Section: Antibiotics For Penile Prosthesis Insertionmentioning

confidence: 56%

This Month in Adult Urology

Smith¹

2020

Journal of Urology

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“…Rates of explantation and non-operative infectious complications were tracked (0% vs. 4% vs. 5%, P=0.130 and 1% vs. 2% vs. 2%, P=0.829). These results were not statistically significant in difference (18). Another study reviewed post-operative antibiotic prescription trends for IPP and artificial urinary sphincter (AUS).…”

Section: Postoperative Antibioticsmentioning

confidence: 96%

Penile implant infection factors: a contemporary narrative review of literature

2021

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We aim to review and summarize published literature that features implanted penile devices and details infection of these devices as a complication. In particular, we will detail the factors that influence infection of penile implants.Background: Types of penile prostheses include inflatable implants and semirigid implants; these are utilized for treatment of erectile dysfunction. Likely the most feared complication of penile implants is infection. There are a handful of factors that are implicated in device infection.Methods: Searches were performed using MEDLINE and PubMed databases using keywords and phrases 'penile implant AND infection'; 'penile prosthesis AND infection'; 'penile implant infection'. We have presented results from our literature search. We divided these into 'Surgical Elements' and 'Patient Selection and Factors.' Each topic is discussed in its own section. Conclusions:Strides have been made since the initial penile prosthesis surgeries to improve infection rates including diabetes control, antibiotic coating of devices, and antibiotic implementation. Going forward, more studies, especially randomized control trials, need to focus on defining levels of diabetic control (sugar control and A1C control), determining the role of metabolic syndrome in infection promotion and determining laboratory values which could be predictive of infection. We present a discussion of important factors to consider in the realm of penile prosthesis infections. In addition, we include studies which discuss topics for future directions in decreasing the number of infections seen with penile prostheses.

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“…Antibiotic prophylaxis and prolonged antibiotic administration for penile prosthesis implantation was retrospectively reviewed by Dropkin et al [23]. Device infection leading to explanation was not required in any of the patients with no risk factors who did not receive any additional antibiotics after implantation.…”

Section: Current Evidence For Antibiotic Stewardship In Urology and U...mentioning

confidence: 99%

Rising significance of antibiotic stewardship in urology and urinary tract infections – a rapid review

Schneidewind

Kranz

Tandoğdu

2021

Current Opinion in Urology

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Purpose of review To give an overview of the significance as well as recent developments in antibiotic stewardship (ABS) in urology and for the treatment of urinary tract infections (UTI). This rapid review is focused on recent publications during the past 18 months. Recent findings Despite the evidence to support the use of ABS interventions in the treatment of UTIs, there remains considerable inappropriate use of antibiotics, up to 68%, especially concerning the treatment of asymptomatic bacteriuria and the overuse of fluoroquinolones. Emerging evidence indicate that ABS programs can improve patient outcome and reduce multidrug-resistant pathogens. Interestingly, in this past 18 months new targets for ABS have been developed, e.g. involvement of a pharmacist, strict adherence to guidelines, improvement of the guidelines itself and understanding the prescription process in the emergency room as well as the analysis of own surveillance data. Summary ABS programs in urology are essential and their significance has become more apparent than ever before. New targets for ABS interventions should be evaluated in prospective controlled clinical trials of their effectiveness to reduce further inappropriate antibiotic use without hindering the treatment of UTIs.

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Penile Prosthesis Insertion in the Era of Antibiotic Stewardship—Are Postoperative Antibiotics Necessary?

Cited by 15 publications

References 0 publications

This Month in Adult Urology

This Month in Adult Urology

Penile implant infection factors: a contemporary narrative review of literature

Rising significance of antibiotic stewardship in urology and urinary tract infections – a rapid review

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