经直肠前列腺活检的抗生素预防措施--请求使用磷霉素。

IF 1.5 4区医学 Q3 UROLOGY & NEPHROLOGY

Urologia Internationalis Pub Date : 2024-10-03 DOI:10.1159/000541798

Philipp Julian Spachmann, Daniel Witt, Johannes Breyer, Stefan Denzinger, Maximilian Burger, Daniel Claudius Vergho, Wolfgang Otto, Marco Julius Schnabel

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引用次数: 0

摘要

导言：根据指南，经直肠随机前列腺活检（TRBP）应在抗生素预防（AP）下进行。德国未批准使用磷霉素-曲美他莫（FOS），但在产品信息中却虚假地将 TRBP 列为适应症。目的是调查单剂量 FOS 下 TRBP 的感染并发症。方法记录了一家大学机构在 2020 年 7 月 1 日至 2021 年 6 月 30 日期间使用 FOS 3000 毫克单剂量 TRBP 的所有情况。共纳入 357 名患者（41-85 岁，中位数 66 岁）。243人接受了首次TRBP治疗，321人接受了核磁共振融合治疗。共采集了10至22个核芯（中位数为14个）。前列腺特异性抗原（PSA）为0.1至1224ng/ml（中位数为7.7ng/ml），前列腺体积为5至263ml（中位数为50ml）。采用卡方检验或费雪精确检验、Mann-Whitney-U 检验和 t 检验进行分析。结果四名患者发生感染（1.1%），与年龄（P=0.849）、PSA（P=0.957）、核数（P=0.905）和体积增加（P=0.456）无显著差异。局限性在于其回顾性。结论并发症发生率为 1.1%，因此单剂量 FOS 足够作为 TRBP 的抗生素预防用药。应在前瞻性研究中对 FOS 单剂量进行重新评估，以获得德国对这一适应症的批准。

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Antibiotic Prophylaxis of Transrectal Biopsy of the Prostate: A Plea for Fosfomycin.

Introduction: According to guidelines, transrectal random biopsy of the prostate (TRBP) is performed under antibiotic prophylaxis (AP). Fosfomycin-trometamol (FOS) is not approved in Germany, but TRBP as indication was listed in the product information falsely. The aim was to investigate infectious complications of TRBP under FOS as a single dose.

Methods: All TRBPs under FOS 3,000 mg as a single dose between July 1, 2020, and June 30, 2021, at a university institution were recorded. 357 patients (41-85 years old, median 66) were included. 243 received first TRBP, 321 TRBP were MRI-fusionated. 10-22 cores were taken (median 14). Prostate-specific antigen (PSA) was 0.1-1224 ng/mL (median 7.7 ng/mL), prostate volume 5-263 mL (median 50 mL). Analysis was performed using Chi square test or Fisher's exact test, Mann-Whitney U test, and t test.

Results: Four patients suffered an infection (1.1%), without significant difference according to age (p = 0.849), PSA (p = 0.957), number of cores (p = 0.905), and increase in volume (p = 0.456). Limiting is the retrospective character.

Conclusion: The complication rate was 1.1%, and FOS single dose therefore represents sufficient AP for TRBP in this collective. FOS as a single dose should be reevaluated in a prospective study to obtain approval in Germany for this indication.

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来源期刊

Urologia Internationalis 医学-泌尿学与肾脏学

CiteScore

3.30

自引率

6.20%

发文量

审稿时长

3-8 weeks

期刊介绍： Concise but fully substantiated international reports of clinically oriented research into science and current management of urogenital disorders form the nucleus of original as well as basic research papers. These are supplemented by up-to-date reviews by international experts on the state-of-the-art of key topics of clinical urological practice. Essential topics receiving regular coverage include the introduction of new techniques and instrumentation as well as the evaluation of new functional tests and diagnostic methods. Special attention is given to advances in surgical techniques and clinical oncology. The regular publication of selected case reports represents the great variation in urological disease and illustrates treatment solutions in singular cases.