822 The Use of Prophylactic Antibiotics Pre-Orchidectomy – a Retrospective Cohort Study. (19th August 2022) - Doherty, J
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.