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Overuse of antimicrobial prophylaxis in low-risk patients undergoing transurethral resection of the prostate

Kathrin Bausch1, Jan Adam Roth2, Hans Helge Seifert1

  • 1Department of Urology, University Hospital Basel, Switzerland / University of Basel, Switzerland.

Swiss Medical Weekly
|February 24, 2018
PubMed
Abstract

Insights

Many urologists do not follow European Association of Urology (EAU) guidelines for antimicrobial prophylaxis in transurethral resection of the prostate (TURP) or photoselective vaporization of the prostate (PVP). This nonadherence, particularly in low-risk patients, necessitates improved monitoring to combat antimicrobial resistance.

Area of Science:

  • Urology
  • Infectious Disease
  • Pharmacology

Background:

  • Antimicrobial prophylaxis is crucial for preventing infectious complications and reducing antimicrobial resistance.
  • European Association of Urology (EAU) guidelines provide recommendations for effective antimicrobial prophylaxis.
  • Transurethral resection of the prostate (TURP) and photoselective vaporization of the prostate (PVP) are common urological procedures.

Purpose of the Study:

  • To assess current antimicrobial prophylaxis practices for low-risk TURP and PVP patients.
  • To compare these practices against EAU guidelines.
  • To identify potential areas for improving adherence and reducing antimicrobial resistance.

Main Methods:

  • An anonymous online survey was distributed to urologists in Germany, Austria, and Switzerland.
  • The survey collected data on urologists' sources of information and prescribing patterns for antimicrobial prophylaxis.
  • Respondents reported practices for patients undergoing TURP or PVP without specific complicating factors.

Main Results:

  • A significant proportion of urologists reported non-routine use of preoperative prophylaxis (42% for TURP, 33% for PVP).
  • Many prescribed non-recommended perioperative regimens (43% for TURP, 52% for PVP).
  • Extended postoperative prophylaxis was common (60% for TURP, 65% for PVP), with 74% of respondents reporting nonadherence to guidelines for TURP.

Conclusions:

  • There is low adherence to EAU antimicrobial prophylaxis guidelines among urologists for TURP and PVP.
  • Current practices deviate from recommendations, potentially increasing infectious complications and resistance.
  • Urgent monitoring and intervention are needed to improve guideline adherence in urological antimicrobial prophylaxis.

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