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The following is a summary of “Critically Evaluating the Role for Postoperative Antibiotics in Patients Undergoing Urethroplasty with Buccal Mucosa Graft: A Claims Database Analysis,” published in the April 2024 issue of Urology by Galansky et al.
This retrospective cohort study aimed to meticulously compare outcomes among patients undergoing first-time urethroplasty with buccal mucosa graft (BMG) who received post-operative antibiotics versus those who did not, utilizing data from the TriNetX claims database from 2008 to 2022. Through meticulous querying using CPT, ICD10, and LOINC codes, researchers identified patients aged over 18 years who underwent primary urethroplasty with BMG and received outpatient antibiotic prescriptions between postoperative days 0-30, contrasting them with those who did not receive antibiotics.
Exclusion criteria encompassed patients with positive pre-operative urine culture or urinary tract infection (UTI) within 30 days pre-operatively. Surgical outcomes, including 5-year revision rates and revision-free survival, were assessed alongside safety outcomes such as new UTI within 30 days, surgical site infection (SSI) within 90 days, or Clostridium difficile infection within 30 days post-urethroplasty. The analysis encompassed 884 patients, 81% in the antibiotic cohort and 19% in the non-antibiotic cohort, meeting the inclusion criteria. Comparative analysis revealed comparable age between cohorts at the time of urethroplasty, suprapubic tube presence, and pre-existing medical comorbidities. Importantly, no significant differences between the antibiotic and non-antibiotic groups were observed in 5-year rates and revision-free survival for endoscopic revision, re-do urethroplasty, or all-cause revision.
Additionally, post-operative rates of UTI, SSI, and Clostridium difficile infection demonstrated no discernible disparities between the two cohorts. In conclusion, this extensive retrospective cohort study suggests that post-operative antibiotics confers no significant benefit on long-term revision rates or perioperative infectious complications in patients undergoing urethroplasty with BMG.
Source: sciencedirect.com/science/article/abs/pii/S0090429524002760