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Ureteroscopy pp 209-216 | Cite as

Informed Consent and Perioperative Antibiotics

  • Christopher L. Allam
  • J. Stuart WolfJr.Email author
Chapter
Part of the Current Clinical Urology book series (CCU)

Abstract

Preoperative preparation for ureteroscopy includes, among other activities, obtaining informed consent and deciding on the use of antimicrobial prophylaxis. Informed consent is essentially the concept that individuals have the right to make decisions affecting their bodies and health. Informed consent must include (1) the inherent and potential hazards of the proposed treatment, (2) the alternatives to the treatment, if any, and (3) the results likely if the patient remains untreated. In the event of litigation regarding informed consent, a plaintiff has a two-part burden. First, it must be proven the physician did not meet the required standard for informed consents. Second, the plaintiff must prove a causal relationship between the physician’s failure to disclose information and a direct damage to the patient.

In general, antimicrobial prophylaxis has been shown to reduce the incidence of surgical wound infection, and as such is recommended for most operations. In the setting of ureteroscopy, the “surgical wound infection” is postoperative urinary tract infection. Based upon evidence from randomized controlled trials, American Urological Association recommends antimicrobial prophylaxis for all ureteroscopies, although some other organizations recommend differently. Published recommendations, in addition to hospital antibiotic policies and local drug resistant patterns, aid in the selection of a specific antimicrobial prophylaxis program. Recommended agents for antimicrobial prophylaxis in association with ureteroscopy include fluoroquinolone, trimethoprim–sulfamethoxazole, aminoglycoside ± ampicillin, first/second generation cephalosporin, or amoxicillin/clavulanate. Duration of prophylaxis should be 24 h or less.

Keywords

Surgical Site Infection Infective Endocarditis Antimicrobial Prophylaxis Stent Removal Surgical Wound Infection 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Pearle MS, Calhoun EA, Curhan GC. Urologic diseases of America project: urolithiasis. J Urol. 2005;173(3):848–57.PubMedCrossRefGoogle Scholar
  2. 2.
    Scales CD, Krupski TL, et al. Practice variation in the surgical management of urinary lithiasis. J Urol. 2011;186(1):146–50.PubMedCrossRefGoogle Scholar
  3. 3.
    Metwalli AB, Metwalli AR, Donovan JF. Informed consent and related legal issues in laparoscopic surgery. In: Smith’s textbook of endourology (2nd ed). Edited by Smith AD, Badlani GH, Bagley DH, Clayman RV, Jordan GH, Kavoussi, B. Lee LR, Lingeman JE, Preminger GM, and Segura JW. Hamilton, Canada: BC Decker, pp. 57–59, 2007.Google Scholar
  4. 4.
    Paterick TJ, Carson GV. Medical informed consent: general considerations for physicians. Mayo Clin Proc. 2008;83(3):313–9.PubMedCrossRefGoogle Scholar
  5. 5.
    Beauchamp TL. Informed consent: its history, meaning and present challenges. Camb Q Healthc Ethics. 2011;20:515–23.PubMedCrossRefGoogle Scholar
  6. 6.
    Schloendorff v. Society of New York Hospital. In: NE. vol 105. NY: 1914. P92 LEXIS 1028.Google Scholar
  7. 7.
    Salgo v. Leland Stanford Jr University Board of Trustess, 317 2d 170 (1957)Google Scholar
  8. 8.
    American Medical Association Code of Medical Ethics: Informed Consent. American Medical Association Web Site. http://www.ama-assn.org/ama/pub/physician-resources/legal-topics/patient-physician-relationship-topics/informed-consent.page. Accessed 16 Nov 2011.
  9. 9.
    The Patient-Physician Relationship: Report of the Council on Ethical and Judicial Affairs (1-A-01). American Medical Association Web Site. http://www.ama-assn.org/ama/pub/about-ama/our-people/ama-councils/council-ethical-judicial-affairs/ceja-reports.page? Accessed 16 Nov 2011.
  10. 10.
    Canterbury v Spence, 464F. 2d 772 (DC Cir 1972)Google Scholar
  11. 11.
    Rostolsky BM. Practice makes perfect: experience-related information should fall within the purview of Pennsylvania’s doctrine of informed consent. Duquesne Law Rev. 2002;40:543–60.PubMedGoogle Scholar
  12. 12.
    Boustani M, Peterson B, Hanson L, et al. Screening for dementia in primary care: a summary of the evidence for the U.S. Preventative Services Task Force. Ann Intern Med. 2003;138:927–37.PubMedGoogle Scholar
  13. 13.
    LaCaze v. Collier, 434 So. 2d 1039, 1048 (La. 1983)Google Scholar
  14. 14.
    Roussel v. Sharp, 569 So. Ed 67 (1990)Google Scholar
  15. 15.
    Cross v. Trapp, 170W. Va 459 (1982)Google Scholar
  16. 16.
    Cheese v. U.S., Not Reported in F. Supp. 2d (2005)Google Scholar
  17. 17.
    Cistrunk v. Oakwoood Heritage Hosp., Not Reported in N.W. 2d (2010)Google Scholar
  18. 18.
    Woods RK, Dellinger EP. Current guidelines for antibiotic prophylaxis of surgical wounds. Am Fam Phyisician. 1998;57(11):2731–40.Google Scholar
  19. 19.
    Bratzler D, Houck PM, Richards C, et al. Use of antimicrobial prophylaxis for major surgery: baseline results from the National Surgical Infection Prevention Project. Arch Surg. 2005;140:174.PubMedCrossRefGoogle Scholar
  20. 20.
    Platt R. Guidelines for perioperative antibiotic prophylaxis. In: Abrutyn E, Goldmann DA, Scheckler WE, editors. Saunders infection control reference service. Philadelphia: W.B. Saunders; 1997. p. 229–34.Google Scholar
  21. 21.
    Hall MJ, DeFrances CJ, et al. National hospital discharge survey: 2007, number 29. Hyattsville, MD: Centers for Disease and Prevention; 2010.Google Scholar
  22. 22.
    Bratzler DW, Houck PM. Surgical Infection Prevention Guideline Writers Workgroup: antimicrobial prophylaxis for surgery: an advisory statement from the National Surgical Infection Prevention Project. Am J Surg. 2005;189:395.PubMedCrossRefGoogle Scholar
  23. 23.
    National Nosocomial Infections Surveillance (NNIS) System. National Nosocomial Infections Surveillance (NNIS) System Report, data summary from January 1992 through June 2004, issued October 2004. Am J Infect Control. 2004;32(8):470–85.CrossRefGoogle Scholar
  24. 24.
    Urban JA. Cost analysis of surgical site infections. Surg Infect. 2006;7:S1–19.CrossRefGoogle Scholar
  25. 25.
    Mangram AJ, Horan TC, Pearson ML, et al. Guideline for prevention of surgical site infection. Infect Control Hosp Epidemiol. 1999;20(4):250–80.PubMedCrossRefGoogle Scholar
  26. 26.
    Culver DH, Horan TC, Gaynes RP, et al. Surgical wound infection rates by wound class, operative procedure and patient risk index. Am J Med. 1991;91(3B):S152–7.CrossRefGoogle Scholar
  27. 27.
    Krizek TJ, Robson MC. Evolution of quantitative bacteriology in wound management. Am J Surg. 1975;130:579–84.PubMedCrossRefGoogle Scholar
  28. 28.
    James RC, MacLeod CJ. Induction of staphylococcal infections in mice with small inocula introduced on sutures. Br J Exp Pathol. 1961;42:266–77.PubMedGoogle Scholar
  29. 29.
    Morrison DC, Ryan JL. Endotoxins and disease mechanisms. Annu Rev Med. 1987;38:417–32.PubMedCrossRefGoogle Scholar
  30. 30.
    Bergamini TM, Corpus Jr RA, Brittian KR, et al. The natural history of bacterial biofilm graft infection. J Surg Res. 1994;56:393–6.PubMedCrossRefGoogle Scholar
  31. 31.
    Wiley AM, Ha’eri GB. Routes of infection: a study of using “tracer particles” in the orthopedic operating room. Clin Orthop. 1979;139:150–5.PubMedGoogle Scholar
  32. 32.
    Letts RM, Doermer E. Conversation in the operating theatre as a cause of airborne bacterial contamination. J Bone Joint Surg Am. 1983;65:357–62.PubMedGoogle Scholar
  33. 33.
    Giamarellou H, Antoniadou A. Epidemiology, diagnosis and therapy of fungal infections in surgery. Infect Control Hosp Epidemiol. 1996;17(8):558–64.PubMedCrossRefGoogle Scholar
  34. 34.
    Schaeffer AJ, Schaeffer EM. Infections of the urinary tract. In: Wein AJ, Kavoussi LR, Novak AC, Partin AW, Peters CA, editors. Campbell-Walsh urology, vol. 1. 10th ed. Philadelphia: Saunders-Elsevier; 2011. p. 257–326.Google Scholar
  35. 35.
    Wolf Jr JS, Bennett CJ, Dmochowski RR, et al. Best practice policy statement on urologic surgery antimicrobial prophylaxis. J Urol. 2008;179:1379–90.PubMedCrossRefGoogle Scholar
  36. 36.
    Owens Jr RC, Donskey CJ, Gaynes RP, Loo VG, Muto CA. Antimicrobial-associated risk factors for Clostridium difficile infection. Clin Infect Dis. 2008;46:S19–31.PubMedCrossRefGoogle Scholar
  37. 37.
    Bobo LD, Dubberke ER, Kollef M. Clostridium difficile in the ICU: the struggle continues. Chest. 2011;140(6):1643–53.PubMedCrossRefGoogle Scholar
  38. 38.
    Monroe S, Polk R. Antimicrobial use and bacterial resistance. Curr Opin Microbiol. 2000;3(5):496–501.PubMedCrossRefGoogle Scholar
  39. 39.
    Enzler MJ, Berbari E, Osmon DR. Antimicrobial prophylaxis in adults. Mayo Clin Proc. 2011;86(7):686–701.PubMedCrossRefGoogle Scholar
  40. 40.
    Christiano AP, Hollowell CM, Kim H, Kim J, et al. Double-blind randomized comparison of single-dose ciprofloxacin versus intravenous cefazolin in patients undergoing endourologic surgery. Urology. 2000;55:182–5.PubMedCrossRefGoogle Scholar
  41. 41.
    Lukkarinen O, Hellström P, Leppilahti M, Kontturi M, Tammela T. Antimicrobial prophylaxis in patients with urinary retention undergoing transurethral prostatectomy. Ann Chir Gynaecol. 1997;86:239.PubMedGoogle Scholar
  42. 42.
    Knopf HJ, Graff JH, Schulze H. Perioperative antibiotic prophylaxis in ureteroscopic stone removal. Eur Urol. 2003;44:115–8.PubMedCrossRefGoogle Scholar
  43. 43.
    Fourcade RO. Antibiotic prophylaxis with cefotaxime in endoscopic extraction of upper urinary tract stones: a randomized study. The Cefotaxime Cooperative Group. J Antimicrob Chemother. 1990;26(Suppl A):77–83.PubMedCrossRefGoogle Scholar
  44. 44.
    Aghamir SMK, Hamidi M, Salavati A, Mohammadi A, Farahmand H, Meysamie AP, Ghorbani B. Is antibiotic prophylaxis necessary in patients undergoing ureterolithotripsy? Acta Med Iran. 2011;49:513–6.PubMedGoogle Scholar
  45. 45.
    Taylor AL, Oakley N, Das S, Parys BT. Day-case ­ureteroscopy: an observational study. BJU Int. 2002;89:181–5.PubMedCrossRefGoogle Scholar
  46. 46.
    Grabe M. Controversies in antimicrobial prophylaxis in urology. Int J Antimicrob Agents. 2004;23:S17–23.PubMedCrossRefGoogle Scholar
  47. 47.
    European Association of Urology. Grabe M, Bishop MC, Bjerklund-Johansen TE, Botto H, et al. Guidelines on urological infections. European Guidelines on-line. Accessed 10 Jan 2012.Google Scholar
  48. 48.
    Kurtz M, Eisner B. Antibiotic use after routine ureteroscopic stone treatment (abstract 1448). J Urol. 2010;182(Suppl):e558.CrossRefGoogle Scholar
  49. 49.
    Eisner B, Kurtz M, Wolf Jr JS. Antibiotic prescription and poor compliance with AUA Best Practice Statement (abstract 2154). J Urol. 2011;185(Suppl):e862.CrossRefGoogle Scholar
  50. 50.
    Wilson W, Taubert KA, Gewitz M, Lockhart PB, Baddour LM, Levison M, et al. Prevention of infective endocarditis. Guidelines form the American Heart Association. A Guideline From the American Heart Association Rheumatic Fever, Endocarditis and Kawasaki Disease Committee on Cardiovascular Disease in the Young and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group. Circulation. 2007;116:1736–54.PubMedCrossRefGoogle Scholar
  51. 51.
    Niel-Weise BS, Van den Broek PJ. Urinary catheter policies for long-term bladder drainage. Cochrane Database Syst Rev 2005;(1):DC004201.Google Scholar
  52. 52.
    Clarke SA, Samuel M, Bobby SA. Are prophylatic antimicrobial necessary with clean intermittent catheterization? A randomized controlled trial. J Pediatr Surg. 2005;40:568.PubMedCrossRefGoogle Scholar
  53. 53.
    Sedor J, Mulholland SG. Hospital-acquired urinary tract infections associated with the indwelling catheter. Urol Clin North Am. 1999;26:821.PubMedCrossRefGoogle Scholar
  54. 54.
    Duclos JM, Larrouturou P, Sarkis P. Timing of antimicrobial prophylaxis with cefotaxime for prostatic resection: better in the operative period or at urethral catheter removal? Am J Surg. 1992;164:21S.PubMedCrossRefGoogle Scholar
  55. 55.
    Ramaswamy K, Ojas S. Antibiotic prophylaxis after uncomplicated ureteroscopic stone treatment: is there a difference? J Endourol. 2011;26(2):122–5.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Endourology Division, Urology DepartmentUniversity of MichiganAnn ArborUSA
  2. 2.Division of Endourology and Stone Disease, Department of UrologyUniversity of Michigan Health SystemAnn ArborUSA

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