344 Effectiveness of Intra-operative Antibiotics in Reducing Post-Orchidectomy Infection Rates and Subsequent Delays in Chemotherapy

Aim Radical inguinal orchidectomy is the gold standard treatment for Testicular cancer. Further adjuvant chemotherapy reduces recurrence. Thus, it is imperative to prevent delays in post-operative chemotherapy. Concerns were raised by our Oncology department regarding post-operative infection rates causing such delays. This audit was undertaken to compare our infection rates with that of BAUS’s generally accepted rate of 2-10% post-orchidectomy and determine if our current local practice of using intra-operative antibiotics with no subsequent antibiotic prophylaxis is sufficient. Method Patients who underwent radical orchidectomy from January 2022 to January 2023 were retrospectively reviewed. Orchidectomies performed for suspected testicular malignancy were identified and their final histology was noted. Electronic notes were read to check for post-operative infection and delays in chemotherapy. Results In total, 29 radical orchidectomies were performed, 10 of which were for suspected testicular malignancy. 2 patients had benign histology. In the other 8 patients, histology confirmed testicular cancer. From these, 6 patients showed no post-operative infection and no delay. 1 patient developed infection, which was managed in primary care, also with no delay to subsequent chemotherapy. 1 patient lacked available notes, so couldn’t be followed up. Conclusions Our audit in a large tertiary centre suggests that our current local practice of using a single dose of intra-operative antibiotics is sufficient to prevent post-operative infection and there is no indication for the routine use of post-operative antibiotic prophylaxis. This was a small cohort of patients. Nonetheless, it contributes to the growing evidence demonstrating that routine post-operative antibiotics aren’t indicated in clean urological surgery.