title: Best practice policy statement on urologic surgery antimicrobial prophylaxis.
abstract: OBJECTIVE
  Antimicrobial prophylaxis is the periprocedural systemic administration of an antimicrobial agent intended to reduce the risk of postprocedural local and systemic infections. The AUA convened a BPP Panel to formulate recommendations on the use of antimicrobial prophylaxis during urologic surgery.
  
  
  METHODS
  Recommendations are based on a review of the literature and the Panel members' expert opinions.
  
  
  RESULTS
  The potential benefit of antimicrobial prophylaxis is determined by patient factors, procedure factors, and the potential morbidity of infection. Antimicrobial prophylaxis is recommended only when the potential benefit outweighs the risks and anticipated costs (including expense of agent and administration, risk of allergic reactions or other adverse effects, and induction of bacterial resistance). The prophylactic agent should be effective against organisms characteristic of the operative site. Cost, convenience, and safety of the agent also should be considered. The duration of antimicrobial prophylaxis should extend throughout the period when bacterial invasion is facilitated and/or likely to establish an infection. Prophylaxis should begin within 60 minutes of the surgical incision (120 minutes for intravenous fluoroquinolines and vancomycin) and generally should be discontinued within 24 hours. The AHA no longer recommends antimicrobial prophylaxis for genitourinary surgery solely to prevent infectious endocarditis. Justifications and recommendations for specific antimicrobial prophylactic regimens for specific categories of urologic procedures are provided.
  
  
  CONCLUSIONS
  The recommendations provided in this document, including specific indications and agents enumerated in the Tables, can assist urologists in the appropriate use of periprocedural antimicrobial prophylaxis.
authors.affiliation: American Urological Association Education and Research, Inc.
authors.forename: J Stuart
authors.initials: JS
authors.lastname: Wolf
authors.forename: Carol J
authors.initials: CJ
authors.lastname: Bennett
authors.forename: Roger R
authors.initials: RR
authors.lastname: Dmochowski
authors.forename: Brent K
authors.initials: BK
authors.lastname: Hollenbeck
authors.forename: Margaret S
authors.initials: MS
authors.lastname: Pearle
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Schaeffer
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D019072:Antibiotic Prophylaxis / Q000592:standards*; D001424:Bacterial Infections / Q000517:prevention & control*; D006801:Humans; D017053:Infection Control / Q000379:methods; D013530:Surgical Wound Infection / Q000517:prevention & control; D013520:Urologic Surgical Procedures
chemical_list: D000900:Anti-Bacterial Agents