Compliance with Antimicrobial Prophylaxis Guidelines in Endourological Procedures: Frequency and Related Outcomes

Sondos  Abdaljaleel; Mariam  Abdeljalil; Oriana Awwad; Ghazi Al Edwan; Mohammad Amaireh; Manar Hamdan; Ahmad Khattab; Tasneem Al-Hourani

doi:10.35516/jjps.v16i2.1541

Authors

Sondos Abdaljaleel Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman, Jordan.
Mariam Abdeljalil Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman, Jordan.
Oriana Awwad Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman, Jordan.
Ghazi Al Edwan Department of Urology, The University of Jordan Hospital, Amman, Jordan.
Mohammad Amaireh Department of Urology, Islamic Hospital, Amman, Jordan.
Manar Hamdan Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman, Jordan.
Ahmad Khattab Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman, Jordan.
Tasneem Al-Hourani Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman, Jordan.

DOI:

https://doi.org/10.35516/jjps.v16i2.1541

Abstract

Introduction: Surgical antimicrobial prophylaxis (SAP), when used appropriately based on evidence-based guidelines, reduces the rate of infectious complications following endourological procedures without compromising patient outcomes.

Aims: to audit the appropriateness of the current SAP used in endourological surgeries based on international guidelines and report their associated outcomes (urinary tract infection (UTI) and bloodstream infection (BSI)).

Methodology: The adherence to international guidelines recommendations; AUA 2019 and EAU 2020, regarding indication, duration, choice, and dose of the antibiotics used in endourological procedures were assessed in two medical centers in Amman/Jordan. Also, patients were asked to conduct laboratory urine test to determine the rate of infectious complications within one-month post-procedure.

Results: Three hundred sixty-one patients were recruited for the study. The adherence rate to guidelines regarding indication, choice, and dose of pre-operative antibiotics was 90.3%, 2.8%, and 77.8% respectively. The duration was concordant with guidelines in only 3.4% of participants. A total of 41.8% of patients completed follow-up. Among those, 4.6% developed bacterial UTIs, and 0.7% developed BSI.

Conclusion: Adherence to SAP guidelines in endourological procedures is far from optimal, especially by an inappropriate selection of broad-spectrum antibiotics as the agent of choice and prolonged use of antibiotics after the procedure in the absence of any documented infectious complication.