Contemporary Antibiotic Management for Urologic Procedures and Infections

Anthony J. Schaeffer, MD, Editor

The challenge to tailor antibiotic choices to the individual patient as well as the specific procedure is ever increasing in the modern era of multi-drug-resistant organisms and increasingly complex patients and surgeries. The urologist faces decisions every day in both clinical practice and the operating room setting on how to effectively utilize antibiotics while taking into account individual patient factors as well as procedural factors. The goals of minimizing the incidence of infections and limiting morbidity from infections are shared by clinicians across the specialties ranging from Cardiology, to Orthopedics, to Infectious Disease, to Obstetrics, to Pediatrics, to Internal Medicine. Collaboration on the part of the physicians is key to managing individual patients with infections that require treatment and in procedures that necessitate prophylaxis. Judicious use of antibiotics in the appropriate doses for the indicated duration helps to limit the development of resistant organisms and to maintain the efficacy of broad spectrum antibiotics for the continued treatment of patients in the future.

In this issue of Urologic Clinics , we focus on antibiotic management in cases specific to the urologist, including penile prosthesis and artificial urinary sphincters, transrectal prostate biopsy, and stone treatment, as well as general open and laparoscopic urologic surgeries. We also address antibiotic management for urologic infections in multiple specific patient scenarios, including UTI in pregnancy, UTI in patients with neurogenic bladder, and infections in the elderly, as well as the workup of pediatric UTI. Sexually transmitted infections and fungal infections are also covered in detail. Our goal is for this issue to provide guidance to physicians in urology as well as other specialties as we all work to effectively treat urologic infections and provide appropriate prophylaxis prior to procedures in order to minimize incidence of infections. Maintaining efficacy of antibiotics, minimizing morbidity from infection, and managing complex patients in the setting of increasingly resistant organisms are challenges best met by a multidisciplinary approach.

Thank you to all who contributed their time and expertise to this issue. We appreciate all the work that went into assembling this comprehensive review and anticipate that it will serve as a guide for clinicians across the specialties as they manage urologic infections in the modern era.

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