LAUSR

OBJECTIVE To evaluate adherence to the AUA best practice statement guidelines regarding antibiotic duration in the peri-operative setting for endoscopic urologic surgery. We assessed concordance to these guidelines among adult urologists at a single academic institution and its correlation with post-operative positive urine cultures as it relates to the revised 2019 best practice statement. METHODS We performed a retrospective review of all adult endoscopic ambulatory urologic surgeries performed over an 18-month period by urologists at our institution. Patient demographics, pre- and post-operative urine cultures, operative details, stent or foley use, and antibiotic prescriptions were reviewed. Chi-squared and linear regression analyses were done. RESULTS 330 patients were included for analysis. 62% of patients were prescribed post-operative antibiotics, for an average of 4 days. Trimethoprim/Sulfamethoxazole and fluroquinolones were most often prescribed (43% and 38%, respectively). Intra-operative stent placement, positive urine culture within 30 days prior to surgery, and a positive urine culture within 1 year prior to surgery predicted antibiotic prescription. No significant differences were seen in rates of positive post-operative urine culture rates between cohorts that received antibiotics post-operatively versus those who did not. CONCLUSIONS At our academic institution, we observed poor concordance with the AUA best practice statement for peri-operative antibiotic prescription after ambulatory endoscopic urologic surgery. Rates of positive post-operative cultures were low and not associated with receipt or duration of antibiotic prescription at the time of surgery, supporting minimal use of antibiotics for most endoscopic cases.