Experience With Prophylactic Gentamicin During Penile Prosthesis Surgery: A Retrospective Comparison of Two Different...

Area of Science:

• Urology
• Infectious Disease
• Surgical Prophylaxis

Background:

• Gentamicin is a broad-spectrum antibiotic frequently used for inflatable penile prosthesis (IPP) surgery prophylaxis.
• Optimal gentamicin dosing for IPP implantation to maximize safety and efficacy requires further investigation.

Purpose of the Study:

• To compare the efficacy and safety of low-dose versus high-dose gentamicin prophylaxis in patients undergoing IPP implantation.

Main Methods:

• A retrospective analysis of 897 patients undergoing IPP placement between April 2012 and April 2016.
• Group 1 (n=490) received low-dose gentamicin (80 mg every 8 hours for 1 day); Group 2 (n=407) received a single high dose (5 mg/kg).
• Infection rates and gentamicin-related toxicities were compared between groups, with all patients also receiving vancomycin.

Main Results:

• No significant differences in patient demographics or IPP infection rates were observed between the low- and high-dose gentamicin groups (1.22% vs. 0.74%, P=.057).
• A trend towards lower infection rates was noted in the high-dose group, though not statistically significant.
• No gentamicin-related toxicities were reported in either group, including the high-dose regimen.

Conclusions:

• High-dose preoperative gentamicin (5 mg/kg) appears safe and may be associated with a lower infection rate for IPP surgery.
• Further research is warranted to confirm the efficacy and establish definitive guidelines for high-dose gentamicin prophylaxis in IPP procedures.