{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T04:52:54Z","timestamp":1782276774453,"version":"3.54.5"},"reference-count":10,"publisher":"Wiley","issue":"5A","license":[{"start":{"date-parts":[[2019,1,20]],"date-time":"2019-01-20T00:00:00Z","timestamp":1547942400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2019,5]]},"abstract":"\n Objectives<\/jats:title>\n To examine compliance and clinical outcomes after implementation of a zero antimicrobial prophylaxis protocol for outpatient cystoscopy in an academic centre.<\/jats:p>\n <\/jats:sec>\n \n Patients and Methods<\/jats:title>\n \n Medical records of all patients who underwent diagnostic cystoscopy in the year preceding and year following protocol implementation were evaluated for urinary tract infection (\n UTI<\/jats:styled-content>\n ) diagnosis within 30\u00a0days of cystoscopy. Variables compared between groups included age, sex, smoking history, benign prostatic hyperplasia (\n BPH<\/jats:styled-content>\n ) diagnosis, diabetes mellitus, immunosuppression, catheter use (indwelling, suprapubic, or intermittent), and previous lower urinary tract reconstruction (augmentation cystoplasty or neobladder).\n UTI<\/jats:styled-content>\n was defined using the National Surgical Quality Improvement Program definition. Rates were compared between groups, and statistical analyses were performed using chi\u2010squared and Fisher's exact tests and multivariable logistic regression, with significance defined as \u03b1 < 0.05.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n In total, 941 patients were included in the analysis (72% men), 513 before protocol initiation, and 427 after. Groups were similar with regard to demographic variables and potential risk factors for infection. After protocol implementation, there was a significant reduction in patients receiving procedural antimicrobial prophylaxis (30% vs 15%;\n P<\/jats:italic>\n < 0.001). The incidence of\n UTI<\/jats:styled-content>\n after cystoscopy was slightly higher in the post\u2010protocol group (2.9\u20133.7%), but the difference was not statistically significant (chi\u2010squared = 0.56,\n P<\/jats:italic>\n = 0.45). The incidence of\n UTI<\/jats:styled-content>\n did not significantly differ with procedural antibiotic prophylaxis or with other antibiotic use at time of cystoscopy. Five out of a total of 31\n UTI<\/jats:styled-content>\n s (16%) over the study period resulted in fever, and four (13%) resulted in urosepsis. The probability of neither complication differed significantly between pre\u2010 and post\u2010protocol groups. The only significant patient\u2010level predictor of post\u2010cystoscopy\n UTI<\/jats:styled-content>\n was catheter use (odds ratio 1.48, 95% confidence interval 1.06\u20132.06).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n Protocol implementation led to a significant decrease in procedural antimicrobial prophylaxis, indicating protocols may be effective tools in promoting antibiotic stewardship.\n UTI<\/jats:styled-content>\n incidence did not change significantly under the protocol, and antibiotic prophylaxis did not decrease infection rate. Our results support catheter use as a risk factor for post\u2010cystoscopy infection, but other patient variables, including those present in the American Urological Association Best Practice statement, were not predictive. In total, this analysis suggests that decreasing antibiotic prophylaxis for cystourethroscopy is safe and can be effective in the outpatient setting.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/bju.14662","type":"journal-article","created":{"date-parts":[[2018,12,22]],"date-time":"2018-12-22T13:19:26Z","timestamp":1545484766000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Safety and effectiveness of zero antimicrobial prophylaxis protocol for outpatient cystourethroscopy"],"prefix":"10.1111","volume":"123","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0012-0785","authenticated-orcid":false,"given":"Emily K.","family":"Clennon","sequence":"first","affiliation":[{"name":"Department of Urology Oregon Health and Science University Portland OR USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann","family":"Martinez Acevedo","sequence":"additional","affiliation":[{"name":"Department of Urology Oregon Health and Science University Portland OR USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1504-9881","authenticated-orcid":false,"given":"Kamran P.","family":"Sajadi","sequence":"additional","affiliation":[{"name":"Department of Urology Oregon Health and Science University Portland OR USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,1,20]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.1990.tb14997.x"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1089\/end.2005.19.1006"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2013.08.054"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2017.10.038"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2007.07093.x"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-013-1034-2"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1159\/000381882"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2008.01.068"},{"key":"e_1_2_7_10_1","unstructured":"BonkatG WagenlehnerFME KovesBet\u00a0al.EAU\u2010ESTRO\u2010SIOG Guidelines on Urological Infections. EAU Guidelines 2018; Edn. presented at the EAU Annual Congress Copenhagen 2018"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2014.08.107"}],"container-title":["BJU International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fbju.14662","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/bjui-journals.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/bju.14662","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T17:52:57Z","timestamp":1761760377000},"score":1,"resource":{"primary":{"URL":"https:\/\/bjui-journals.onlinelibrary.wiley.com\/doi\/10.1111\/bju.14662"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,1,20]]},"references-count":10,"journal-issue":{"issue":"5A","published-print":{"date-parts":[[2019,5]]}},"alternative-id":["10.1111\/bju.14662"],"URL":"https:\/\/doi.org\/10.1111\/bju.14662","archive":["Portico"],"relation":{},"ISSN":["1464-4096","1464-410X"],"issn-type":[{"value":"1464-4096","type":"print"},{"value":"1464-410X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,1,20]]},"assertion":[{"value":"2019-01-20","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}