MP46-06 HIGH-RISK PATIENTS UNDERGOING HoLEP HAVE FEWER INFECTIONS WITH A LONGER COURSE OF PREOPERATIVE ANTIBIOTICS: A RETROSPECTIVE MULTI-INSTITUTIONAL STUDY

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology III (MP46)1 May 2024MP46-06 HIGH-RISK PATIENTS UNDERGOING HoLEP HAVE FEWER INFECTIONS WITH A LONGER COURSE OF PREOPERATIVE ANTIBIOTICS: A RETROSPECTIVE MULTI-INSTITUTIONAL STUDY Nikhil Pramod, Fabrice Henry, Suruchi Ramanujan, William Jevnikar, Jim Bena, Ryan Schwartz, Jaxon Jeffrey, Samuel Sorkhi, Ruben Sauer, Shannon McNall, Samantha Freeman, Kevin Wymer, Jessica Mandeville, Simone Civellaro, Mitchell Humphreys, Naeem Bhojani, and Smita De Nikhil PramodNikhil Pramod , Fabrice HenryFabrice Henry , Suruchi RamanujanSuruchi Ramanujan , William JevnikarWilliam Jevnikar , Jim BenaJim Bena , Ryan SchwartzRyan Schwartz , Jaxon JeffreyJaxon Jeffrey , Samuel SorkhiSamuel Sorkhi , Ruben SauerRuben Sauer , Shannon McNallShannon McNall , Samantha FreemanSamantha Freeman , Kevin WymerKevin Wymer , Jessica MandevilleJessica Mandeville , Simone CivellaroSimone Civellaro , Mitchell HumphreysMitchell Humphreys , Naeem BhojaniNaeem Bhojani , and Smita DeSmita De View All Author Informationhttps://doi.org/10.1097/01.JU.0001008668.53858.38.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: There are minimal data to guide antibiotic management of patients undergoing holmium laser enucleation of the prostate (HoLEP) for benign prostatic hyperplasia (BPH). Specifically, management of high-risk patients who are catheter dependent or have positive preoperative urine cultures varies widely. We aimed to evaluate the effect of preoperative antibiotic duration on infectious complications in high-risk patients undergoing HoLEP. METHODS: A multi-institutional retrospective review of patients undergoing HoLEP between 2018-2023 at five institutions was performed. Patients were defined as high-risk if they were catheter-dependent (indwelling urethral catheter, self-catheterization, or suprapubic tube) or had a positive preoperative urine culture pre-operatively. These patients were categorized into long course (>3 days) or short course (≤3 days) of pre-operative antibiotics. The primary outcome was 30-day infectious complications defined as a positive urine culture with symptoms consistent with a urinary tract infection (UTI). A t-test or Wilcoxon rank-sum test was used for continuous variables and Fischer's exact test was used for categorical variables. Logistic regression analysis was conducted to identify associations with infectious complications. RESULTS: Our cohort included 407 patients, of whom 146 (36%) and 261 (64%) were categorized as short course and long course of pre-operative antibiotics, respectively. Median pre-operative antibiotic duration was 1 day (IQR: 0-3 days) and 7 days (IQR: 5-7 days) in the short and long cohorts, respectively. 30 day post-op infectious complications occurred in 11 (7.6%) patients who received a short course of antibiotics and 5 (1.9%) patients who received a long course of antibiotics (OR (95% CI) = 0.24 (0.07, 0.67); p=0.009). Variables such as age, positive urine culture, and post-op antibiotics duration were not significantly associated with post-operative infection after propensity score weighting. CONCLUSIONS: In high-risk patients undergoing HoLEP, infectious complications were significantly lower with a long-course vs. short-course of antibiotics. Further prospective trials are needed to identify optimal pre-operative antibiotic regimens. Source of Funding: N/A © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e754 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Nikhil Pramod More articles by this author Fabrice Henry More articles by this author Suruchi Ramanujan More articles by this author William Jevnikar More articles by this author Jim Bena More articles by this author Ryan Schwartz More articles by this author Jaxon Jeffrey More articles by this author Samuel Sorkhi More articles by this author Ruben Sauer More articles by this author Shannon McNall More articles by this author Samantha Freeman More articles by this author Kevin Wymer More articles by this author Jessica Mandeville More articles by this author Simone Civellaro More articles by this author Mitchell Humphreys More articles by this author Naeem Bhojani More articles by this author Smita De More articles by this author Expand All Advertisement PDF downloadLoading ...