[经直肠前列腺活检的抗生素预防:氟喹诺酮类药物的适应症限制和抗生素管理]。

Der Urologe. Ausg. A Pub Date : 2022-02-01 Epub Date: 2021-08-18 DOI:10.1007/s00120-021-01618-1
Kathrin Rothe, Christiane Querbach, Dirk H Busch, Jürgen E Gschwend, Katharina Hauner
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引用次数: 0

摘要

背景:经直肠前列腺活检(TRPB)是诊断前列腺癌的金标准,也是最常见的泌尿科干预措施之一。经直肠前列腺穿刺活检(TRPB)建议使用短期抗生素预防(PAP)。由于德国联邦药品和医疗器械研究所限制使用氟喹诺酮类抗生素,因此需要重新评估氟喹诺酮预防性前列腺穿刺术(PAP)作为标准治疗的价值:本研究旨在分析PAP治疗TRPB的临床实践,重点关注感染性并发症以及氟喹诺酮类PAP与复方新诺明类PAP之间的潜在差异:我们对2019年1月3日至2021年1月28日期间TRPB患者的临床和微生物学特征进行了回顾性单中心研究:共纳入508名男性患者,中位年龄为68岁。其中,55.9%的患者接受了复方新诺明-PAP治疗,40.0%接受了氟喹诺酮-PAP治疗。介入后并发症发生率为 5.5%,其中 50.0% 为感染性并发症。使用氟喹诺酮AP和复方新诺明AP的患者的并发症发生率没有差异。介入治疗后并发症的尿培养结果显示,病原体对所使用的 PAP 药物具有抗菌性,这表明耐药菌的产生:结论:与氟喹诺酮类 PAP 相比,用于 TRPB 的复方新诺明 PAP 与感染性并发症的增加无关。在 TRPB 之前进行培养以确定抗菌药耐药性,有助于有针对性地使用 PAP,从而减少并发症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

[Antibiotic prophylaxis for transrectal prostate biopsy : In the context of restricted indications for fluoroquinolones and antibiotic stewardship].

[Antibiotic prophylaxis for transrectal prostate biopsy : In the context of restricted indications for fluoroquinolones and antibiotic stewardship].

Background: Transrectal prostate biopsy (TRPB) is the gold standard for prostate cancer diagnosis and among the most common urological interventions. Short-term antibiotic prophylaxis (PAP) is recommended for TRPB. Fluoroquinolone-PAP as standard of care needs to be revaluated due to the restrictions on the use of fluoroquinolone antibiotics by the German Federal Institute for Drugs and Medical Devices.

Objectives: The aim of the study was to analyze clinical practice of PAP for TRPB with focus on infectious complications and potential differences between fluoroquinolone-PAP and cotrimoxazole-PAP.

Methods: We performed a retrospective monocentric study of clinical and microbiological characteristics of patients with TRPB between 3 January 2019 and 28 January 2021.

Results: A total of 508 men were included; median age was 68 years. In all, 55.9% of our cohort received cotrimoxazole-PAP and 40.0% fluoroquinolone-PAP. Postinterventional complications occurred in 5.5%, of those 50.0% were infectious complications. Complication rate did not differ between patients with fluoroquinolone-PAP and cotrimoxazole-PAP. Urinary cultures in case of postinterventional complications yielded pathogens with antimicrobial resistance against the used PAP substance indicating selection of resistant bacteria.

Conclusion: Cotrimoxazole-PAP for TRPB is not associated with an increase of infectious complications compared to fluoroquinolone-PAP. Cultures obtained prior to TRPB to identify antimicrobial resistance facilitate targeted PAP and therefore can reduce complications.

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