Rosen GH, Kanake S, Golzy M, et al. - Researchers herein investigated antimicrobial susceptibility patterns in the United States in order to determine optimal regimens for perioperative antimicrobial prophylaxis in transurethral procedures.

• Procurement of data was done from 40 states.

• The studied microbes varied significantly in sensitivity to studied antibiotics.

• First generation cephalosporins and trimethoprim-sulfamethoxazole are included in current first line recommendations for antimicrobial prophylaxis; the two have mean coverage for E coli, Proteus, and Klebsiella of 82%, 80%, and 87% respectively and 74%, 80%, and 93%, respectively.

• Susceptibility to aminoglycosides and third generation cephalosporin is 91%, 92%, and 96%, respectively, and 92%, 99%, and 94%, respectively.

• Findings suggest overall poor predicted coverage of current first line recommended antimicrobials for prophylaxis in transurethral procedures.

• Although there are alternatives exhibiting higher predicted susceptibility, uncertainty remains concerning the clinical significance of this and risk of resultant antimicrobial resistance.