Comparison of ciprofloxacin versus fosfomycin versus fosfomycin plus trimethoprim/sulfamethoxazole for preventing infections after transrectal prostate biopsy.

Autor: Bovo A; Department of Urology, Cantonal Hospital Aarau, Tellstrasse 25, 5001, Aarau, Switzerland. alberto.bovo@ksa.ch., Kwiatkowski M; Department of Urology, Cantonal Hospital Aarau, Tellstrasse 25, 5001, Aarau, Switzerland.; Medical Faculty, University Hospital Basel, Basel, Switzerland.; Department of Urology, Academic Hospital Braunschweig, Brunswick, Germany., Manka L; Department of Urology, Academic Hospital Braunschweig, Brunswick, Germany.; Department of Urology, Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Potsdam, Germany., Wetterauer C; Medical Faculty, University Hospital Basel, Basel, Switzerland.; Department of Urology, University Hospital Basel, Basel, Switzerland.; Department of Medicine, Faculty of Medicine and Dentistry, Danube Private University, 3500, Krems, Austria., Fux CA; Department of Infectious Diseases and Hospital Hygiene, Cantonal Hospital Aarau, Aarau, Switzerland., Cattaneo M; Department of Clinical Research, University of Basel, 4001, Basel, Switzerland., Wyler SF; Department of Urology, Cantonal Hospital Aarau, Tellstrasse 25, 5001, Aarau, Switzerland.; Medical Faculty, University Hospital Basel, Basel, Switzerland., Prause L; Department of Urology, Cantonal Hospital Aarau, Tellstrasse 25, 5001, Aarau, Switzerland.
Jazyk: angličtina
Zdroj: World journal of urology [World J Urol] 2024 May 28; Vol. 42 (1), pp. 356. Date of Electronic Publication: 2024 May 28.
DOI: 10.1007/s00345-024-05048-4
Abstrakt: Background: To evaluate antibiotic prophylaxis in transrectal prostate biopsies due to the recommendation of the European Medicines Agency (EMA): We describe our single center experience switching from ciprofloxacin to fosfomycin trometamol (FMT) alone and to an augmented prophylaxis combining fosfomycin and trimethoprim/sulfamethoxazole (TMP/SMX).
Methods: Between 01/2019 and 12/2020 we compared three different regimes. The primary endpoint was the clinical diagnosis of an infection within 4 weeks after biopsy. We enrolled 822 men, 398 (48%) of whom received ciprofloxacin (group-C), 136 (16.5%) received FMT (group-F) and 288 (35%) received the combination of TMP/SMX and FMT (group-BF).
Results: Baseline characteristics were similar between groups. In total 37/398 (5%) postinterventional infections were detected, of which 13/398 (3%) vs 18/136 (13.2%) vs 6/288 (2.1%) were detected in group-C, group-F and group-BF respectively. The relative risk of infectious complication was 1.3 (CI 0.7-2.6) for group-C vs. group-BF and 2.8 (CI 1.4-5.7) for group-F vs. group-BF respectively.
Conclusion: The replacement of ciprofloxacin by fosfomycin alone resulted in a significant increase of postinterventional infections, while the combination of FMT and TMP/SMX had a comparable infection rate to FQ without apparent adverse events. Therefore, this combined regimen of FMT and TMP/SMX is recommended.
(© 2024. The Author(s).)
Databáze: MEDLINE
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