Critically evaluating the role for postoperative antibiotics in patients undergoing urethroplasty with buccal mucosa graft: a claims database analysis

You have accessJournal of UrologyCME1 Apr 2023MP78-02 CRITICALLY EVALUATING THE ROLE FOR POSTOPERATIVE ANTIBIOTICS IN PATIENTS UNDERGOING URETHROPLASTY WITH BUCCAL MUCOSA GRAFT: A CLAIMS DATABASE ANALYSIS Logan Galansky, Andrew Gabrielson, and Andrew Cohen Logan GalanskyLogan Galansky More articles by this author , Andrew GabrielsonAndrew Gabrielson More articles by this author , and Andrew CohenAndrew Cohen More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003355.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Although many consider administration of antibiotics after urethroplasty dogma, there is lack of evidence regarding the benefit for postoperative antibiotics. We compare perioperative and post-surgical outcomes among patients undergoing first-time urethroplasty with use of buccal mucosa graft (BMG) who receive postoperative antibiotics versus those who do not. METHODS: A retrospective cohort study was conducted using TriNetX research network, a claims database of 110 million patient encounters between 2008-2022. Using applicable CPT, ICD10, and LOINC codes, patients>18 years old undergoing primary urethroplasty with use of BMG, who received perioperative intravenous antibiotics (IVAb), and either received an outpatient prescription for antibiotics between postoperative day 0-30 or did not were queried. Patients with positive pre-operative urine culture or urinary tract infection (UTI) within 30 days prior to urethroplasty were excluded. Surgical outcomes included 5-year revision rates and revision-free survival. Safety outcomes included new UTI within 30 days, surgical site infection (SSI) or clostridium difficile infection within 90 days of the procedure. RESULTS: We identified 645 patients (505 [78%] antibiotic cohort, 140 [22%] no-antibiotic cohort) that met inclusion criteria. There was no difference in mean age at time of urethroplasty, presence of suprapubic tube, or pre-operative rates of common medical comorbidities between cohorts (Table 1). There was no difference in type of IVAb between groups. There was no difference in 5-year rates and revision-free survival for all-cause revision (18.2% vs. 15.7%, log-rank p=0.15), endoscopic revision (10.3% vs. 12.1%, log-rank p=0.94), or surgical revision (11.1% vs. 8.6%, log-rank p=0.17) between groups. Rates of UTI within 30 days, SSI within 90 days, and clostridium difficile infection within 90 days were similar between groups. CONCLUSIONS: In this large retrospective cohort study of patients undergoing urethroplasty with use of BMG, we observed no significant benefit from the use of postoperative antibiotics on revision rates or infectious complications. Limitations of this analysis include inability to delineate between continuous versus short course prophylaxis. Source of Funding: NA © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1131 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Logan Galansky More articles by this author Andrew Gabrielson More articles by this author Andrew Cohen More articles by this author Expand All Advertisement PDF downloadLoading ...