822 The Use of Prophylactic Antibiotics Pre-Orchidectomy – a Retrospective Cohort Study

Abstract

Abstract Aim NICE guidance recommends the use of antibiotic prophylaxis in clean-contaminated procedures and when a prosthetic is placed. However, the use in orchidectomies is not specified under the treatment summary heading of ‘Urological Procedures, Antibacterial Prophylaxis’. The use of prophylactic antibiotics pre-orchidectomy varied amongst senior urologists within a District General Hospital, where no specific protocol was in use. This retrospective cohort study aimed to decipher if the use of prophylactic antibiotics reduced post-operative infection incidence following radical orchidectomies. Method 50 consecutive orchidectomies, performed between February 2019 and July 2021, were analysed. It was identified whether the patient had antibiotics administered pre-operatively and if they developed a subsequent wound infection through post-operative ward rounds, clinic letters and presentations to the Emergency Department. Orchidectomies performed by general surgeons were excluded from analysis. Results Of the 50 orchidectomies analysed, 30 patients received pre-operative antibiotics, four of whom subsequently developed a post-operative infection. Of the 20 patients that did not receive prophylactic antibiotics, nine developed a post-operative infection. The relative risk was calculated at 0.2963 with a 70.4% relative risk reduction if prophylactic antibiotics were administered. Chi squared tests calculated a p-value of 0.012 highlighting statistical significance. Eight patients had primary prosthesis placed at the time of orchidectomy, all of whom received prophylactic antibiotics. Conclusion Prophylactic antibiotics were effective in preventing post-orchiectomy wound infections and routine local protocols should advise the use in orchidectomies, which classify as clean-contaminated procedures as per NICE guidance.