Dr. Joshua Sterling

Typical protocol for urethroplasty, so everyone gets a urine culture two weeks before.

If there are any bacteria there, I will treat it.

As long as it speciates out and I get sensitivities from it, I treat that.

I only get a proof of cure for MRSA.

So otherwise, I just give them a course.

It's usually by the time it comes back, just through the operating room, just because of the timing.

So I usually end a 14-day course, and it's going to go through the operating room.

They get perioperative or...

Periprocedural antibiotics based on that culture.

And then that's it.

I don't give them anything.

If it was somebody who was colonized or had a particularly virulent bacteria, I will give them a dose when I take the catheter out.

But yeah, like I said, I really pulled back in terms of antibiotic use in my urethroplasty patients.

Okay.

That's not entirely true.

Anyone who gets a rug when it gets pulled gets one dose of fosfomycin because of a rug.

But for whatever reason, for timing, it's kind of four weeks and I'm just going to pull the catheter right now.

Okay.

So I don't do anything in treating it for that, but I will go back to previous cultures for what I give them in the operating room.

Gotcha.