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Tailored perioperative antimicrobial prophylaxis in urological surgery : myth or reality?

Grabe, Magnus J. LU and Lundström, Karl Johan (2017) In Current Opinion in Urology 27(2). p.112-117
Abstract

PURPOSE OF THE REVIEW: The controversies surrounding perioperative antimicrobial prophylaxis (AMP) are about the use and especially misuse of antibiotics. The overall lack of evidence to facilitate a rational perioperative AMP policy in urological surgery and the postoperative infectious complications remain a challenge. Therefore, a basic tool to aid decision-making would be useful. A model based on the patients’ risk factors, the level of contamination and grading of surgical procedures is discussed. RECENT FINDINGS: A series of studies have shown that infectious complications and healthcare-associated infections remain consistently at an average of 10%, with a great variation in frequency dependent on the patients’ preoperative... (More)

PURPOSE OF THE REVIEW: The controversies surrounding perioperative antimicrobial prophylaxis (AMP) are about the use and especially misuse of antibiotics. The overall lack of evidence to facilitate a rational perioperative AMP policy in urological surgery and the postoperative infectious complications remain a challenge. Therefore, a basic tool to aid decision-making would be useful. A model based on the patients’ risk factors, the level of contamination and grading of surgical procedures is discussed. RECENT FINDINGS: A series of studies have shown that infectious complications and healthcare-associated infections remain consistently at an average of 10%, with a great variation in frequency dependent on the patients’ preoperative status and the type, severity and contamination level of the surgical procedure. Preoperative patient assessment and preparation are key factors for well tolerated surgery and recovery. Adherence to the guidelines appears to reduce both the prescription of antimicrobials and the total costs without risking the patient outcome. Several studies of a series of interventions such as cystoscopy, endoscopic stone surgery and selected clean-contaminated interventions give support to the model. Bacteriuria, upgrading the patient to the contaminated level, requires preoperative control. SUMMARY: The discussed model assists the urologists in decision-making on perioperative AMP and contributes to a responsible use of antibiotics.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Current Opinion in Urology
volume
27
issue
2
pages
112 - 117
publisher
Lippincott Williams & Wilkins
external identifiers
  • scopus:84995743526
  • wos:000393775800005
ISSN
0963-0643
DOI
10.1097/MOU.0000000000000363
language
English
LU publication?
yes
id
f5f1e29a-4f6a-4d2a-ab26-34ee6138b93e
date added to LUP
2016-12-05 07:37:18
date last changed
2018-01-07 11:38:34
@article{f5f1e29a-4f6a-4d2a-ab26-34ee6138b93e,
  abstract     = {<p>PURPOSE OF THE REVIEW: The controversies surrounding perioperative antimicrobial prophylaxis (AMP) are about the use and especially misuse of antibiotics. The overall lack of evidence to facilitate a rational perioperative AMP policy in urological surgery and the postoperative infectious complications remain a challenge. Therefore, a basic tool to aid decision-making would be useful. A model based on the patients’ risk factors, the level of contamination and grading of surgical procedures is discussed. RECENT FINDINGS: A series of studies have shown that infectious complications and healthcare-associated infections remain consistently at an average of 10%, with a great variation in frequency dependent on the patients’ preoperative status and the type, severity and contamination level of the surgical procedure. Preoperative patient assessment and preparation are key factors for well tolerated surgery and recovery. Adherence to the guidelines appears to reduce both the prescription of antimicrobials and the total costs without risking the patient outcome. Several studies of a series of interventions such as cystoscopy, endoscopic stone surgery and selected clean-contaminated interventions give support to the model. Bacteriuria, upgrading the patient to the contaminated level, requires preoperative control. SUMMARY: The discussed model assists the urologists in decision-making on perioperative AMP and contributes to a responsible use of antibiotics.</p>},
  author       = {Grabe, Magnus J. and Lundström, Karl Johan},
  issn         = {0963-0643},
  language     = {eng},
  number       = {2},
  pages        = {112--117},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {Current Opinion in Urology},
  title        = {Tailored perioperative antimicrobial prophylaxis in urological surgery : myth or reality?},
  url          = {http://dx.doi.org/10.1097/MOU.0000000000000363},
  volume       = {27},
  year         = {2017},
}