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

To determine if patients discharged without antibiotics after IPP insertion were at increased risk of infectious complications compared to patients discharged with oral antibiotics at our institution and to patients in other contemporary series.

Medical records of patients who underwent IPP insertion from 2013 through 2017 were reviewed. Group 1 patients had no risk factors for infectious complications and did not receive postoperative antibiotics, Group 2 patients had risk factors for infectious complications but did not receive postoperative antibiotics, and Group 3 patients had risk factors for infectious complications and received postoperative antibiotics.

Of the 222 men who met inclusion criteria, 88 (40%) were placed in Group 1, 48 (21%) in Group 2, and 86 (39%) in Group 3. The mean number of risk factors for infection was lower for Group 2 compared to Group 3 (1.08 + 0.28 vs. 1.24 + 0.46, p = 0.013). Median (IQR) follow up did not vary between Groups 1, 2, and 3, respectively (4.6 (1.8-7.2) vs. 3.5 (1.4-6.9) vs. 4.5 (1.4-7.4) months, p = 0.146). Rates of explantation due to device infection (0 vs. 4 vs. 5%, p = 0.130) and non-operative infectious complications (1 vs. 2 vs. 2%, p = 0.829) did not vary between groups.

Patients undergoing IPP insertion appear unlikely to benefit from the routine administration of postoperative antibiotics. In the current era of antibiotic stewardship these findings have the potential for substantial individual and population health benefits.

The Journal of urology. 2019 Oct 03 [Epub ahead of print]

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

Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee., Vanderbilt University School of Medicine, Nashville, Tennessee.

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