Open AccessAssessment of Guideline Discordance With Antimicrobial Prophylaxis Best Practices for Common Urologic Procedures
Author(s) -
Chelsea L. Khaw,
Anthony D. Oberle,
Brian C. Lund,
Jason A. Egge,
Brett H. Heintz,
Bradley A. Erickson,
Daniel J. Livorsi
Publication year - 2018
Publication title -
jama network open
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.278
H-Index - 39
ISSN - 2574-3805
DOI - 10.1001/jamanetworkopen.2018.6248
Subject(s) - medicine , guideline , antimicrobial stewardship , medical record , audit , psychological intervention , emergency medicine , intensive care medicine , antibiotic resistance , antibiotics , management , pathology , microbiology and biotechnology , economics , biology , psychiatry
Key Points Question Do urologic clinicians within the Veterans Health Administration system adhere to the American Urological Association’s antimicrobial prophylaxis guideline for endoscopic urologic procedures? Findings In this cohort study analyzing the medical records of 375 patients at 5 Veterans Health Administration hospitals and the administrative data of 29 530 records throughout the entire Veterans Health Administration system, antimicrobial prescribing was guideline discordant in nearly 60% of patients, the rate of excessive postprocedural antimicrobial use was high, and nearly 40% of records received a median of 3 excess days of antimicrobial therapy. Agreement between these 2 data sources was high. Meaning In patients who underwent common urologic procedures, the rates of guideline-discordant antimicrobial use were high, mainly because of overprescribing of postprocedural antimicrobial agents.
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