Do Antifungals and Local Anesthetic Affect the Efficacy of Antibiotic Dipping Solution?

Mishra, Kirtishri; Bukavina, Laura; Long, Lisa; Sherif, R.; Gupta, Shubham; Muncey, Wade; Thirumavalavan, Nannan; Ghannoum, Mahmoud A.; Loeb, Aram

doi:10.1016/j.jsxm.2020.12.020

Cited by 5 publications

(1 citation statement)

References 22 publications

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“…An in vitro study by Mishra et al examined whether adding antifungal agents into the dipping solution could have an impact on antibiotic efficacy [ 41 ]. The incorporation of antifungal solution (amphotericin B) did not diminish antibiotic efficacy and exhibited significant antifungal effects against Candida species without compromising the zone of inhibition of other bacterial pathogens in vitro.…”

Section: Reviewmentioning

confidence: 99%

Unveiling the Hidden Perils: A Comprehensive Review of Fungal Infections in Inflatable Penile Prosthesis Surgery

Natsos,

Tatanis,

Lekkou

et al. 2024

JPM

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Inflatable penile prosthesis (IPP) surgery is an effective treatment for erectile dysfunction (ED), but infections pose a significant threat to its success. Current guidelines lack antifungal recommendations, despite rising fungal infection rates post-IPP surgery. This review examines epidemiology, risk factors (including diabetes mellitus, immunosuppression, and obesity), and pathogenesis, highlighting the role of biofilm formation in device contamination. Clinical manifestations vary from acute to delayed, with fungal biofilms presenting challenges in diagnosis. Prophylactic strategies, including broad-spectrum antibiotics and antifungals, are crucial, with evidence suggesting a 92% reduction in infections. With fungal infections showing lower salvage rates, management involves culture-guided treatment, irrigation, and oral antibiotics. Future research aims to understand biofilm mechanisms and develop biomaterials to reduce infection rates. Implementing antifungal therapy, along with standard practices like the no-touch technique and antibiotic dips, is crucial in preventing IPP infections.

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Section: Reviewmentioning

confidence: 99%

Unveiling the Hidden Perils: A Comprehensive Review of Fungal Infections in Inflatable Penile Prosthesis Surgery

Natsos,

Tatanis,

Lekkou

et al. 2024

JPM

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Penile prosthesis salvage: a historical look at the Mulcahy technique and a review of the latest literature

et al. 2022

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Effect of 0.05% chlorhexidine gluconate in water on the hydrophilic inflatable penile prosthesis: biocompatibility, adherence, and dip time

Griggs

Karpman

Jones

et al. 2023

The Journal of Sexual Medicine

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Background Rates of infection after inflatable penile prosthesis range from 1% to 3%; however, a new surgical irrigation solution is Food and Drug Administration cleared as antimicrobial wound lavage and appears to be safe for patients and noncaustic during hydrophilic inflatable penile prosthesis (hIPP) dipping and irrigation. Aim To evaluate if 0.05% chlorhexidine (CHG) lavage is caustic to the hIPP coating and if dip adherence is dependent on time. Methods Preconnected hIPP devices were tested at a Coloplast research and development laboratory. The devices were soaked in the 0.05% CHG lavage solution or normal saline for 1, 15, 30, and 60 minutes. Subsequently, all parts were dried for 15 minutes in a 35 °C oven. A Congo red dye test was performed following a Coloplast-validated and Food and Drug Administration–cleared test method to ensure product reliability. Implants were then visually inspected for deleterious effects as well as dip coverage. In addition, we evaluated 0.05% CHG lavage solution vs previously published hIPP dipping solutions. Outcomes 0.05% CHG lavage does not appear to damage the hIPP coating, and adherence of this solution is not dependent on dip time. Results All components of the preconnected hydrophilic IPPs were tested for coating adherence and defects. All tested IPPs achieved a “satisfactory” coating, meaning a uniform coat without flaking or clumping. Furthermore, there were no noticeable caustic effects or differences in coating adherence between the normal saline–soaked control and 0.05% CHG–coated arms with increasing dip time. A review of the literature for 0.05% CHG lavage solutions vs previously published hIPP dipping solutions revealed that it may have some advantages over previously reported antibiotic solutions. Clinical Implications This study serves as a foundation to introduce 0.05% CHG lavage to the urologic literature as a potentially new “magic bullet” irrigation. Strengths and Limitations Major strengths of the study are that it is the first study of its kind to address the question of what dip duration should be used and whether it is scientifically reproducible. A limitation is the in vitro model, thus needing validation in a clinical setting. Conclusion 0.05% CHG does not appear to negatively affect the hIPP coating or differ in adherence with increasing dip time; however, long-term device performance has not been verified.

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Do Antifungals and Local Anesthetic Affect the Efficacy of Antibiotic Dipping Solution?

Cited by 5 publications

References 22 publications

Unveiling the Hidden Perils: A Comprehensive Review of Fungal Infections in Inflatable Penile Prosthesis Surgery

Unveiling the Hidden Perils: A Comprehensive Review of Fungal Infections in Inflatable Penile Prosthesis Surgery

Penile prosthesis salvage: a historical look at the Mulcahy technique and a review of the latest literature

Effect of 0.05% chlorhexidine gluconate in water on the hydrophilic inflatable penile prosthesis: biocompatibility, adherence, and dip time

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