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Infection & Prophylaxis Pharmacotherapy

Antimicrobial pharmacotherapy spans the perioperative window, UTI treatment, recurrent-UTI prevention (antibiotic and non-antibiotic), antifungals, and device-specific infection protocols (IPP, AUS, mesh). Two areas have recent evidence: non-antibiotic recurrent-UTI prevention (vaginal estrogen, methenamine, cranberry) addressed by the AUA/CUA/SUFU 2025 guideline and the ALTAR and ImpresU trials and Tan-Kim retrospective cohort; and local IPP prophylaxis protocols questioned by the PUMP and Barham observational IPP studies.

For perioperative pharmacology by surgical phase (bowel prep, VTE prophylaxis, anticoagulation reversal, stress-dose steroids, postop ileus management) see Perioperative ERAS.

  • Perioperative Antibiotic ProphylaxisWho needs antibiotics before urologic surgery, which ones, and for how long, including prosthetic cases.
  • UTI Treatment AntibioticsChoosing antibiotics for uncomplicated and complicated UTI, including newer agents for resistant organisms.
  • UTI Suppressive & Prophylactic TherapyA stepwise approach to preventing recurrent UTI, from vaginal estrogen and methenamine to antibiotic prophylaxis.
  • Non-Antibiotic UTI PreventionEvidence on cranberry, methenamine, vaginal estrogen, D-mannose and other non-antibiotic strategies for recurrent-UTI prevention.
  • AntifungalsAntifungal agents for candiduria, fungal UTI and prophylaxis around prosthetic and urinary-tract surgery.
  • Prosthetic Infection & BiofilmDevice-specific infection management for IPP, AUS, mesh, and sling. The biofilm-formation timeline and antibiotic-coated-implant evidence; PUMP/Barham observational evidence; salvage vs explant decision-making; staged reimplantation.