Antimicrobial prophylaxis is effective in a wide range of urological procedures and has contributed to reduce the rate of postoperative infectious complications [1]. Adherence to European Association of Urology (EAU) guidelines on antimicrobial prophylaxis reduces antimicrobial usage without increasing postoperative infection rates, lowers the prevalence of resistant uropathogens, and saves costs [2]. Nevertheless, adherence to EAU guidelines is not optimal. Antimicrobials are used for clean procedures without evidence and the types of antimicrobials used are not according to guidelines recommendations [3]. Also, antimi- crobial prophylaxis is often extended beyond the recom- mended 24-h period with important consequences such as appearance of multi-resistant organisms, including strains resistant to newer agents, worsened clinical outcome, and increased treatment costs [2]. Patients as well as the hospital ecology are unnecessary exposed to broad-spectrum anti- microbials and their adverse effects. It is of outmost importance to preserve the arsenal of effective antimicrobials at a hospital level and even beyond the hospital. A revision of clinical practice in terms of antimicrobial prophylaxis is urgently needed. The correct use of antimicrobial prophy- laxis in urological procedures rests on three pillars: (1) knowledge of the local pathogen profile and antimicrobial resistance, (2) careful evaluation of patient-related risk factors for the development of infectious complications after urological procedures, and (3) adherence to EAU guidelines on urological infections. This clinical consultation guide aims to give a short update on evidence-based recommendations.
How to use antimicrobial prophylaxis in urological procedures
Bartoletti RMethodology
2016-01-01
Abstract
Antimicrobial prophylaxis is effective in a wide range of urological procedures and has contributed to reduce the rate of postoperative infectious complications [1]. Adherence to European Association of Urology (EAU) guidelines on antimicrobial prophylaxis reduces antimicrobial usage without increasing postoperative infection rates, lowers the prevalence of resistant uropathogens, and saves costs [2]. Nevertheless, adherence to EAU guidelines is not optimal. Antimicrobials are used for clean procedures without evidence and the types of antimicrobials used are not according to guidelines recommendations [3]. Also, antimi- crobial prophylaxis is often extended beyond the recom- mended 24-h period with important consequences such as appearance of multi-resistant organisms, including strains resistant to newer agents, worsened clinical outcome, and increased treatment costs [2]. Patients as well as the hospital ecology are unnecessary exposed to broad-spectrum anti- microbials and their adverse effects. It is of outmost importance to preserve the arsenal of effective antimicrobials at a hospital level and even beyond the hospital. A revision of clinical practice in terms of antimicrobial prophylaxis is urgently needed. The correct use of antimicrobial prophy- laxis in urological procedures rests on three pillars: (1) knowledge of the local pathogen profile and antimicrobial resistance, (2) careful evaluation of patient-related risk factors for the development of infectious complications after urological procedures, and (3) adherence to EAU guidelines on urological infections. This clinical consultation guide aims to give a short update on evidence-based recommendations.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
