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Die am 20.12.2024 konsentierte, interdisziplin\u00e4re AWMF-S3-Leitlinie zur perioperativen Antibiotikaprophylaxe (AWMF S3, 2024) liefert einen umfassenden, evidenzbasierten Rahmen zur Indikationsstellung, Substanzwahl, Dosierung, zum Zeitpunkt der Antibiotikagabe und zur Qualit\u00e4tssicherung der PAP \u00fcber alle chirurgischen Disziplinen hinweg, mit einem dezidierten Kapitel f\u00fcr spezifisch ausgew\u00e4hlte urologische Eingriffe.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methoden<\/jats:title>\n                    <jats:p>Die Leitlinie folgt dem AWMF-Regelwerk, nutzt systematische Literaturrecherchen mit GRADE-Bewertung, operationalisiert Empfehlungen, Statements und Expertenkonsens und verankert die Umsetzung in struktur-, prozess- und ergebnisorientierten Qualit\u00e4tsindikatoren. Die urologischen Eingriffe wurden per PICOS-Schema definiert und mit evidenzbasierten Empfehlungen versehen. Erg\u00e4nzend werden die Empfehlungen der EAU-Guideline \u201eUrological infections\u201c (EAU, 2025) vergleichend diskutiert.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ergebnisse<\/jats:title>\n                    <jats:p>\n                      Allgemeine Kernaussagen sind: Pr\u00e4zise Indikationsstellung, intraven\u00f6se Gabe 30\u201360\u202fmin vor OP-Beginn. Leitlinienkonform ist die \u201eSingle-shot-PAP\u201c das Standardvorgehen; eine \u00dcberschreitung ist nur in klar begr\u00fcndeten Ausnahmef\u00e4llen vorgesehen. Bei ausgew\u00e4hlten Hochrisikoeingriffen kann eine auf\n                      <jats:italic>\u2264<\/jats:italic>\n                      \u202f24\u202fh begrenzte perioperative Strategie leitlinienkonform sein. Die Nachdosierung bezeichnet eine zus\u00e4tzliche intraoperative Gabe bei verl\u00e4ngerter Operationsdauer oder relevantem Blutverlust. Eine dar\u00fcberhinausgehende postoperative Fortf\u00fchrung \u00fcber den \u201esingle shot\u201c hinaus ist nur in klar definierten Ausnahmef\u00e4llen vorgesehen und wird im Manuskript gesondert dargestellt. F\u00fcr die Urologie gilt: Voraussetzung f\u00fcr die risikoadaptierte PAP ist eine pr\u00e4operative Urindiagnostik zum Ausschluss einer asymptomatischen Bakteriurie. Bei transrektaler Prostatabiopsie soll eine PAP durchgef\u00fchrt werden, idealerweise zielgerichtet nach Rektalabstrich (t-PAP). Bei transperinealer Biopsie kann auf eine PAP verzichtet werden, sofern eine asymptomatischen Bakteriurie ausgeschlossen wurde und eine suffiziente Hautantiseptik erfolgt; bei Risikopatienten sollte eine PAP appliziert werden. Vor elektiver TURP (transurethrale Resektion der Prostata) soll eine PAP erfolgen, w\u00e4hrend bei der TURB (transurethrale Resektion der Harnblase) eine Prophylaxe nur f\u00fcr Risikopatienten empfohlen wird. Vor radikaler Zystektomie soll eine PAP obligat durchgef\u00fchrt werden. Vor ESWL (extrakorporale Sto\u00dfwellenlithotripsie) sollte keine routinem\u00e4\u00dfige PAP erfolgen, sie kann jedoch bei Hochrisikokonstellationen erwogen werden. Bei minimalinvasiven Tumorablationen und interventionsradiologischen Verfahren (z.\u202fB. Prostata-Arterien-Embolisation) ist eine routinem\u00e4\u00dfige Prophylaxe nicht indiziert, eine selektive Anwendung kann bei definierten Risikokonstellationen sinnvoll sein.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Schlussfolgerung<\/jats:title>\n                    <jats:p>Die AWMF-S3 2024 bietet f\u00fcr die interventionelle und operative Urologie ein robustes Fundament, um Infektionspr\u00e4vention und \u201eAntibiotic Stewardship\u201c zusammenzuf\u00fchren. Sie erm\u00f6glicht, soweit es die Datenlage zul\u00e4sst, eine risikoadaptierte Reduktion unn\u00f6tiger Antibiotikagaben ohne Erh\u00f6hung des Infektionsrisikos und zeigt eine weitgehende Konsistenz mit den EAU-Empfehlungen zur Prophylaxe bei urologischen Eingriffen.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00120-026-02877-6","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T18:26:02Z","timestamp":1783535162000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Perioperative und periinterventionelle Antibiotikaprophylaxe: Allgemeine und urologiespezifische Empfehlungen der AWMF-S3-Leitlinie","Perioperative and peri-interventional antibiotic prophylaxis: general and urology-specific recommendations from the German Interdisciplinary S3 guideline"],"prefix":"10.1007","author":[{"given":"Katharina","family":"Hauner","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Kranz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Wagenlehner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonja","family":"Hansen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gernot","family":"Bonkat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Magistro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"May","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,8]]},"reference":[{"issue":"4","key":"2877_CR1","doi-asserted-by":"publisher","first-page":"463","DOI":"10.2174\/0115748863338553250106111958","volume":"20","author":"S Nadeem","year":"2025","unstructured":"Nadeem\u00a0S, Hameed\u00a0AA, Gillani\u00a0SW, Rathore\u00a0HA (2025) Reported Postoperative Surgical Site Infections in Tertiary Care Hospitals, Systematic Review of Recent Literature. 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