San Diego, CA USA (UroToday.com) In this session, Dr. Krasnow and colleagues from the Brigham and Women’s Hospital presented work looking at the optimal antibiotic prophylaxis regimen in patients undergoing radical cystectomy. The objective of the study was to examine variability in antimicrobial prophylaxis and which regimen resulted in the fewest infectious, soft tissue, and wound related events (ISWE).
The premier prospective database was used for the present analysis and captured patients undergoing radical cystectomy from 2003-2013 for whom perioperative antibiotic prophylaxis information was available. The primary outcome was ISWE, which were defined using the Agency for Healthcare Research (AHRQ) Clinical Classification Software. Secondary outcomes were infectious events in the absence of soft tissue, soft tissue and wound only events, and length of stay.
The authors demonstrated a large amount of variability regarding antimicrobial prophylaxis in patients undergoing radical cystectomy. Only about 28% adherence to guideline was noted. The regimen with the best outcomes was combination therapy with 1st generation cephalosporin or penicillin with an aminoglycoside or 2nd/3rd generation cephalosporin. The optimal antibiotic regimen and duration should be further studied to optimize perioperative ISWE.
Presented By: Ross Krasnow, MD