028 Adherence to the AUA Penile Prosthesis Antibiotic Prophylaxis Guidelines in Diabetic Patients is Associated with Significantly Higher Risks of Device Infection

Abstract

The most devastating complication following penile prosthesis (PP) implantation is an infection requiring device explantation. Current AUA guidelines recommend antibiotic prophylaxis before PP implantation with an aminoglycoside and either a 1st/2nd generation cephalosporin or vancomycin. We conducted a multi-institutional study to examine infection rates in diabetic patients undergoing PP implantation with different prophylactic antibiotic regimens, and compared outcomes based on adherence to AUA guidelines. Between April 2003 and August 2018, data was collected from 18 different institutions, and charts of 923 patients with diabetes receiving primary PP implantation were reviewed. Perioperative antibiotic regimen was recorded for each patient and the primary outcome was post-operative infection rates, the secondary outcomes were explantation and revision rates. Patients had a median follow up time of 8 months (range: 0 – 157). Patients were included in the analysis only if they had complete information regarding perioperative antibiotics and outcomes. Univariate comparisons of proportions were completed for rates of infection between different antibiotic regimens. Multivariate analysis controlling for immediate pre-operative blood glucose levels, Hemoglobin A1c, age, diabetes-related complications, and surgical approach was completed for rates of infection, revision, and explantation rates.