J Pediatr Urol. 2025 Oct 29:S1477-5131(25)00560-1. doi: 10.1016/j.jpurol.2025.10.001. Online ahead of print.
ABSTRACT
INTRODUCTION: Surgical site infections (SSIs) are rare but important complications in pediatric urologic surgery. While surgical antibiotic prophylaxis (SAP) has led to a decrease in SSIs, it may be unnecessary for Class I/Clean surgical cases. In 2019 the American Urological Association (AUA) Best Practice Statements (BPS) on urologic procedures and antimicrobial prophylaxis were updated advising that routine antimicrobial prophylaxis for Class I cases may not be necessary. The objectives of this study were to evaluate current practices regarding SAP for Class I procedures among pediatric urologists and to assess the impact of the 2019 AUA BPS update on clinical practice.
METHODS: An anonymous cross-sectional survey was distributed via email to Societies for Pediatric Urology (SPU) members. Data collected from the survey included provider demographics, factors influencing antibiotic use, procedure-specific practices, awareness of the 2019 AUA BPS update, and any subsequent changes to individual practices.
RESULTS: A total of 85 of 388 (22 %) SPU members completed the survey. The use of prophylactic antibiotics varied by procedure, with the highest reported use for laparoscopic surgeries (39-48 %) and testicular torsion exploration (39 %), and lowest use for meatotomy and circumcision (3 %). While 79 % of respondents were aware of the 2019 AUA BPS update, only 37 % of those aware modified their practice accordingly. National guidelines, personal experience, and Tanner stage were the most frequently cited factors influencing practice patterns among respondents. Additionally, 21 % of respondents believed even a single dose of antimicrobial prophylaxis contributes to antibiotic resistance.
CONCLUSION: Despite broad awareness of the 2019 AUA BPS update, SAP practice patterns remain variable among pediatric urologists. Further efforts and research are needed to promote evidence-based antimicrobial stewardship in the field of pediatric urology.
PMID:41162267 | DOI:10.1016/j.jpurol.2025.10.001
