AUA-recommended Antibiotic Prophylaxis for Primary Penile Implantation Results in a Higher, Not Lower, Risk for Postoperative Infection: A Multicenter Analysis
David W. Barham, Nikolaos Pyrgidis, Martin Gross, Muhammed Hammad, Daniel Swerdloff, Jake Miller, Abdullah Alkhayal, Khalid Alrabeeah, Robert Andrianne, Arthur L. Burnett, Kelli Gross, Georgios Hatzichristodoulou, James M. Hotaling, Tung‐Chin Hsieh, Adam Jones, James M. Jones, Aaron Lentz, Jason A Levy, Vaibhav Modgil, Daniar Osmonov, Sung Hun Park, Ian Pearce, Paul Perito, Hossein Sadeghi‐Nejad, Maxime Sempels, Alfredo Suarez‐Sarmiento, Jay Simhan, Koenraad van Renterghem, J Warner, Matthew Ziegelmann, Faysal A. Yafi
Abstract
PURPOSE: Our aim was to determine if the AUA-recommended prophylaxis (vancomycin + gentamicin alone) for primary inflatable penile prosthesis surgery is associated with a higher infection risk than nonstandard regimens. MATERIALS AND METHODS: We performed a multicenter, retrospective study of patients undergoing primary inflatable penile prosthesis surgery. Patients were divided into those receiving vancomycin + gentamicin alone and those receiving any other regimen. A Cox proportional-hazards model was constructed adjusted for major predictors. A subgroup analysis to identify the appropriate dosage of gentamicin was also performed. RESULTS: = .1). CONCLUSIONS: Vancomycin + gentamicin alone for antibiotic prophylaxis for primary inflatable penile prosthesis surgery is associated with a higher infection risk than nonstandard antibiotic regimens while antifungal use is associated with lower infection risk. A critical review of the recommended antimicrobial prophylactic regimens is needed. Prospective research is needed to further elucidate best practices in inflatable penile prosthesis antimicrobial prophylaxis.