title: Assessment of antibiotic prophylaxis prescribing patterns for TURP: A need for Canadian guidelines?
abstract: BACKGROUND
  While antibiotic prophylaxis is recommended to all patients undergoing transurethral resection of prostate (TURP), little data exist regarding prescribing patterns of urologists prior to this procedure. Here, we sought to determine real-world antibiotic prophylaxis prescribing patterns at a high volume Canadian institution and determine compliance rates to recommendations put forth by the American Urological Association's (AUA) Best Practice Statement (BPS) on antimicrobial prophylaxis.
  
  
  METHODS
  A retrospective chart review of 488 patients undergoing TURP was conducted. Electronic medical records were reviewed to determine antibiotics prescribed 3 hours preoperatively and 24 hours postoperatively. For patients without a catheter, compliance was defined as those receiving an antibiotic prior to TURP. In patients with an indwelling catheter, compliance was defined as those receiving antibiotics from two different classes prior to surgery.
  
  
  RESULTS
  Overall, a total of 30 antibiotic regimens were utilized. The most common single antibiotic regimens prescribed were ciprofloxacin (32%), cefazolin (25%) and gentamicin (3%). In those patients with indwelling Foley catheters prior to TURP, a significant increase in gentamicin, as well as combination antibiotic regimens, was noted. The compliance rate with the AUA BPS in patients without a preoperative catheter was 81%, while the compliance rate for patients with an indwelling catheter prior to TURP was 37%.
  
  
  CONCLUSIONS
  Collectively, our results demonstrate that prescribing patterns vary significantly prior to TURP, with compliance to AUA BPS being lower than anticipated. Overall, these results support educational efforts in this area, and the development of Canadian recommendations to improve uptake by practicing urologists.
authors.affiliation: Southern Alberta Institute of Urology, Division of Urology, Department of Surgery, University of Calgary, Calgary, AB;
authors.forename: Keith A
authors.initials: KA
authors.lastname: Lawson
authors.forename: Jan K
authors.initials: JK
authors.lastname: Rudzinski
authors.forename: Ingrid
authors.initials: I
authors.lastname: Vicas
authors.forename: Kevin V
authors.initials: KV
authors.lastname: Carlson
references.citation: Eur Urol. 2001 Mar;39(3):272-6
references.pmid: 11275718
references.citation: J Antimicrob Chemother. 1982 Jun;9(6):471-7
references.pmid: 7107549
references.citation: J Urol. 1983 Jun;129(6):1123-4
references.pmid: 6854784
references.citation: J Urol. 1955 Jul;74(1):123-8
references.pmid: 13243511
references.citation: J Urol. 2005 Apr;173(4):1175-81
references.pmid: 15758736
references.citation: BJU Int. 2003 Oct;92(6):589-91
references.pmid: 14511040
references.citation: Urology. 1985 Jul;26(1 Suppl):15-7
references.pmid: 4040291
references.citation: Br J Surg. 1987 Mar;74(3):192-4
references.pmid: 3552106
references.citation: Br J Urol. 1982 Oct;54(5):542-6
references.pmid: 7171961
references.citation: J Infect Dis. 1973 Jan;127(1):49-55
references.pmid: 4683102
references.citation: J Urol. 1983 Aug;130(2):305-8
references.pmid: 6308283
references.citation: Br J Urol. 1986 Aug;58(4):450-2
references.pmid: 3530364
references.citation: Urology. 2000 Feb;55(2):182-5
references.pmid: 10688075
references.citation: Urology. 2011 May;77(5):1183-7
references.pmid: 20974484
references.citation: J Urol. 2008 Apr;179(4):1379-90
references.pmid: 18280509
references.citation: J Antimicrob Chemother. 1981 Feb;7(2):209-10
references.pmid: 6260729
references.citation: Am J Med. 1989 Nov 30;87(5A):252S-254S
references.pmid: 2686427
references.citation: Eur Urol. 2005 Apr;47(4):549-56
references.pmid: 15774257
references.citation: J Urol. 1987 Aug;138(2):245-52
references.pmid: 3298693
references.citation: Am J Med. 1989 Nov 30;87(5A):250S-251S
references.pmid: 2589373
references.citation: J Urol. 2002 Feb;167(2 Pt 1):571-7
references.pmid: 11792921
references.citation: J Urol. 1972 Nov;108(5):719-21
references.pmid: 5081705
references.citation: Int J Antimicrob Agents. 2001 Apr;17(4):331-41
references.pmid: 11295418
references.citation: Urol Res. 1984;12(6):275-7
references.pmid: 6098060
references.citation: Sao Paulo Med J. 2004 Jan 8;122(1):4-7
references.pmid: 15160519
references.citation: Br J Urol. 1988 Jun;61(6):494-7
references.pmid: 3401658