{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T10:35:57Z","timestamp":1793702157172,"version":"4.5.1"},"reference-count":30,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,5,20]],"date-time":"2023-05-20T00:00:00Z","timestamp":1684540800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurourology and Urodynamics"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction and Objective<\/jats:title><jats:p>Perioperative antimicrobial prophylaxis is crucial for prevention of prosthesis and patient morbidity after artificial urinary sphincter (AUS) placement. While antibiotic guidelines exist for many urologic procedures, adoption patterns for AUS surgery are unclear. We aimed to assess trends in antibiotic prophylaxis for AUS and outcomes relative to American Urological Association (AUA) Best Practice guidelines.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The Premier Healthcare Database was queried from 2000 to 2020. Encounters involving AUS insertion, revision\/removal, and associated complications were identified via ICD and CPT codes. Premier charge codes were used to identify antibiotics used during the insertion encounter. AUS\u2010related complication events were found using patient hospital identifiers. Univariable analysis between hospital\/patient characteristics and use of guideline\u2010adherent antibiotics was done via chi\u2010squared and Kruskal\u2013Wallis tests. A multivariable logistic mixed effects model was used to assess factors related to the odds of complication, specifically the use of guideline\u2010adherent versus nonadherent regimens.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 9775 patients with primary AUS surgery, 4310 (44.1%) received guideline\u2010adherent antibiotics. The odds of guideline\u2010adherent regimen use increased 7.7% per year with 53.0% (830\/1565) receiving guideline\u2010adherent antibiotics by the end of the study period. Patients with guideline\u2010adherent regimens had a decreased risk of any complication (odds ratio [OR]: 0.83, 95% confidence interval [CI]: 0.74\u20130.93) and surgical revision (OR: 0.85, 95% CI: 0.74\u20130.96) within 3 months; however, no significant difference in infection within was noted (OR: 0.89, 95% CI: 0.68\u20131.17) within 3 months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Adherence to AUA antimicrobial guidelines for AUS surgery appears to have increased over the last two decades. While guideline\u2010adherent regimens were associated with decreased risk of any complication and surgical intervention, no significant association was found with risk of infection. Surgeons appear to be increasingly following AUA recommendations for antimicrobial prophylaxis for AUS surgery, however, further level 1 evidence should be obtained to demonstrate conclusive benefit of these regimens.<\/jats:p><\/jats:sec>","DOI":"10.1002\/nau.25206","type":"journal-article","created":{"date-parts":[[2023,5,20]],"date-time":"2023-05-20T14:03:18Z","timestamp":1684591398000},"page":"1421-1430","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Trends over 20 years of antimicrobial prophylaxis for artificial urinary sphincter surgery"],"prefix":"10.1002","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3217-0608","authenticated-orcid":false,"given":"Helen H.","family":"Sun","sequence":"first","affiliation":[{"name":"Urology Institute University Hospitals Cleveland Health System Cleveland Ohio USA"},{"name":"Case Western Reserve University School of Medicine Cleveland Ohio 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