Avoiding Urologic Surgery Infections

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The AUA released a new set of guidelines to address nosocomial infections.
The AUA released a new set of guidelines to address nosocomial infections.

An AUA-sponsored panel has developed a “Best Practice Statement” to guide antimicrobial prophylaxis.

The Best Practice Statement on Urologic Surgery Antimicrobial Prophylaxis was developed by the American Urological Association (AUA) and published in the April issue of the Journal of Urology (2008; 179:1379-1390). Corrected tables, which added some agents not included in the original publication and provided some clarifications, were published in the November issue of the Journal of Urology (2008;180:2262-2263).

 

Additionally, the revised table was published in the November issue of AUANews (vol. 13, issue 11, 2008).  The document is available online at the AUA Web site at www.auanet.org/content/guidelines-and-quality-care/clinical-guidelines/main-reports/antimicroprop08.pdf, accessed October 22, 2008.

Periprocedural infections are an important health care concern. Surgical-site infections occur after 5% of clean extra-abdominal procedures and are even more frequent after intra-abdominal operations. UTIs are the most common form of nosocomial infections.

 

Despite clear demonstrations that appropriate antimicrobial prophylaxis reduces the incidence of surgical-site infections and postoperative UTIs, there is wide variation in practice. Standardizing antimicrobial prophylaxis and promulgating its proper application will improve patient care and reduce costs. Additionally, several national groups as well as the Centers for Medicare and Medicaid Services have requested specialty-specific recommendations for periprocedural antimicrobial prophylaxis to assist in the creation of pay-for-performance measures.

In response to these patient and organizational needs, the American Urological Association (AUA) convened a panel of experts and issued its Best Practice Statement on Urologic Surgery Antimicrobial Prophylaxis. Because of insufficient information to base recommendations solely on literature meta-analyses, the panel reviewed existing data supplemented by the members' expert opinions.

 

Levels of evidence were assigned to the supporting literature, ranging from randomized trials and meta-analyses of randomized trials to case series and expert opinion, to clarify the strength of the recommendations.

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