Fosfomycin antimicrobial prophylaxis for transrectal ultrasound-guided biopsy of the prostate: A prospective randomised study
| Autor: | Hussien Abdeldiam, Ahmed Fahmy, Ahmed Elabbady, Omer Algebaly, Tamer Abo Youssif, Ahmed Kotb |
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| Rok vydání: | 2016 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty Urology 030106 microbiology 030232 urology & nephrology FQ fluoroquinolone Fosfomycin 03 medical and health sciences 0302 clinical medicine Transrectal ultrasound-guided biopsy Prostate Internal medicine ESBL extended-spectrum β-lactamase Biopsy medicine In patient medicine.diagnostic_test business.industry Incidence (epidemiology) Limiting MDR multidrug-resistant Antimicrobial Surgery TRUSBx TRUS-guided biopsy of the prostate medicine.anatomical_structure Antimicrobial prophylaxis Original Article Transrectal ultrasound guided biopsy business medicine.drug |
| Zdroj: | Arab Journal of Urology |
| ISSN: | 2090-598X |
| DOI: | 10.1016/j.aju.2016.05.003 |
| Popis: | Objectives To compare the incidence of infectious complications after single-dose fosfomycin vs. standard fluoroquinolone (FQ)-based prophylaxis in patients undergoing transrectal ultrasound-guided biopsy of the prostate (TRUSBx), as there is an alarming trend worldwide of increasing resistance to FQs limiting their suitability as appropriate prophylaxis for TRUSBx. Patients and methods A prospective study was conducted in 412 consecutive patients undergoing TRUSBx between February 2012 and June 2015. Patients were randomly divided into two groups; Group 1 (202 patients) who received single-dose fosfomycin (3 g, orally) 1–2 h before TRUSBx and Group 2 (210 patients) who received routine empirical prophylaxis in the form of oral ciprofloxacin 500 mg and metronidazole 500 mg at least 1 h before TRUSBx and continued this twice daily for 3 days before TRUSBx. We recorded all febrile and afebrile urinary tract infections (UTIs) within the 4 weeks after the procedure. Results There was no difference in baseline demographics between the two groups. Total infectious complications occurred in four (1.9%) and 18 (8.5%) patients in Groups 1 and 2, respectively, which was statistically significant (P = 0.001). Escherichia coli was the most common isolated pathogen from urine cultures in all patients with infectious complications (68%). The other isolated bacterium, Klebsiella pneumoniae, was detected in four patients (18%). Urine cultures revealed FQ-resistant strains (73%), all of which were extended-spectrum β-lactamase-producing E. coli and K. pneumoniae. Conclusions Single-dose fosfomycin before TRUSBx significantly reduces infectious complications when compared with standard therapy. Fosfomycin is an effective agent for antimicrobial prophylaxis in patients undergoing TRUSBx, particularly in populations where FQ resistance is common. |
| Databáze: | OpenAIRE |
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