1
|
Stangl FP, Schneidewind L, Wagenlehner FM, Schultz-Lampel D, Baeßler K, Naumann G, Schönburg S, Anheuser P, Winkelhog-Gran S, Saar M, Hüsch T, Kranz J. Do or Don't: Results of a Multinational Survey on Antibiotic Prophylaxis in Urodynamics. Antibiotics (Basel) 2023; 12:1219. [PMID: 37508315 PMCID: PMC10376729 DOI: 10.3390/antibiotics12071219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 07/20/2023] [Accepted: 07/21/2023] [Indexed: 07/30/2023] Open
Abstract
Antibiotic prophylaxis contributes substantially to the increase in antibiotic resistance rates worldwide. This investigation aims to assess the current standard of practice in using antibiotic prophylaxis for urodynamics (UDS) and identify barriers to guideline adherence. An online survey using a 22-item questionnaire designed according to the Checklist for Reporting Results of Internet E-Surveys (CHERRIES) was circulated among urologists and gynecologists in Austria, Germany, and Switzerland between September 2021 and March 2022. A total of 105 questionnaires were eligible for analysis. Out of 105 completed surveys, most responders (n = 99, 94%) regularly perform dipstick urine analysis prior to urodynamics, but do not perform a urine culture (n = 68, 65%). Ninety-eight (93%) participants refrain from using antibiotic prophylaxis, and sixty-eight (65%) use prophylaxis if complicating factors exist. If asymptomatic bacteriuria is present, approximately 54 (52%) participants omit UDS and reschedule the procedure until antimicrobial susceptibility testing is available. Seventy-eight (78%) participants do not have a standard procedure for antibiotic prophylaxis in their department. Part of the strategy against the development of bacterial resistance is the optimized use of antibiotics, including antibiotic prophylaxis in urodynamics. Establishing a standard procedure is necessary and purposeful to harmonize both aspects in the field of urological diagnostics.
Collapse
Affiliation(s)
- Fabian P Stangl
- Department of Urology, University Hospital of Bern, 3010 Bern, Switzerland
| | - Laila Schneidewind
- Department of Urology, University Medical Centre Rostock, 18057 Rostock, Germany
| | - Florian M Wagenlehner
- Clinic for Urology, Paediatric Urology and Andrology, Justus-Liebig-University Giessen, 35390 Giessen, Germany
| | - Daniela Schultz-Lampel
- Southwest Continence Center, Schwarzwald-Baar-Klinikum, 78052 Villingen-Schwenningen, Germany
| | - Kaven Baeßler
- Continence-and Pelvic-Floor-Centre, Franziskus-Hospital Berlin, 10787 Berlin, Germany
| | - Gert Naumann
- Women's Hospital, Helios Clinic Erfurt, 99089 Erfurt, Germany
- University Women's Clinic, Heinrich-Heine-University Düsseldorf, 40225 Düsseldorf, Germany
| | - Sandra Schönburg
- Department of Urology and Kidney Transplantation, Martin Luther University, 06108 Halle (Saale), Germany
| | - Petra Anheuser
- Klinik für Urologie, Asklepios Klinik Wandsbek, 22043 Hamburg, Germany
| | - Susanne Winkelhog-Gran
- Clinic for Urology and Pediatric Urology, St.-Antonius Hospital gGmbH, Academic Teaching Hospital of RWTH Aachen, 52249 Eschweiler, Germany
| | - Matthias Saar
- Department of Urology and Paediatric Urology, University Clinic RWTH Aachen, 52074 Aachen, Germany
| | - Tanja Hüsch
- Clinic for Urology and Pediatric Urology, University Medicine Johannes-Gutenberg-University Mainz, 55131 Mainz, Germany
| | - Jennifer Kranz
- Department of Urology and Kidney Transplantation, Martin Luther University, 06108 Halle (Saale), Germany
- Department of Urology and Paediatric Urology, University Clinic RWTH Aachen, 52074 Aachen, Germany
| |
Collapse
|
2
|
Schneidewind L, Stangl FP, Dräger DL, Wagenlehner FME, Hakenberg OW, Kranz J. [What is the proportion of infectiology in the specialization urology? : A pilot study to underline the significance of Antibiotic Stewardship in urology]. UROLOGIE (HEIDELBERG, GERMANY) 2022; 61:1237-1242. [PMID: 35925110 PMCID: PMC9636103 DOI: 10.1007/s00120-022-01898-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 06/20/2022] [Indexed: 09/19/2023]
Abstract
BACKGROUND Urinary tract infections account for one of the most bacterial infectious diseases worldwide. OBJECTIVES The primary aim of this pilot project was to identify the relative percentage of antibiotic use in comparison to all patients in a university medical center for the better establishment of antibiotic stewardship (ABS) programs. MATERIAL AND METHODS This is an epidemiological pilot project. In the time period of three months it was evaluated which relative percentage of the patients was treated with antibiotics for bacterial urinary tract infection in comparison to all patients. RESULTS In summary, about 40% of all urological patients received an antibiotic treatment against urinary tract infections or as perioperative prophylaxis against bacterial infection in the operating room (OR). The antibiotic use at the urological ward is highest in comparison to ambulance or OR. CONCLUSION Infectious diseases, especially bacterial infections, account for a significant part of urology. This knowledge is essential to establish ABS programs and to tackle the progression of antibiotic resistance. Detailed studies are necessary to understand antibiotic prescription practice in urology to develop targeted ABS interventions.
Collapse
Affiliation(s)
- Laila Schneidewind
- Urologische Klinik und Poliklinik, Universitätsmedizin Rostock, Schillingallee 35, 18055, Rostock, Deutschland.
| | - Fabian P Stangl
- Universitätsklinik für Urologie, Inselspital Bern, Bern, Schweiz
| | - Desiree L Dräger
- Urologische Klinik und Poliklinik, Universitätsmedizin Rostock, Schillingallee 35, 18055, Rostock, Deutschland
| | - Florian M E Wagenlehner
- Klinik für Urologie, Kinderurologie und Andrologie, Justus-Liebig-Universität-Gießen, Gießen, Deutschland
| | - Oliver W Hakenberg
- Urologische Klinik und Poliklinik, Universitätsmedizin Rostock, Schillingallee 35, 18055, Rostock, Deutschland
| | - Jennifer Kranz
- Klinik für Urologie und Kinderurologie, Uniklinik RWTH Aachen, Aachen, Deutschland
- Universitätsklinik und Poliklinik für Urologie, Universitätsklinikum Halle (Saale), Halle (Saale), Deutschland
| |
Collapse
|