The effectiveness of a short perioperative course with pivampicillin/pivmecillinam in transurethral prostatic...

We analysed the bacteriological findings in 261 patients undergoing transurethral prostatic resection (TUR) and receiving either an oral course of pivampicillin/pivmecillinam (PAPM) or parenteral cefotaxime (CFT) in a randomized clinical trial. 123/261 patients had bacteriuria before TUR; 80% of the bacteria were gram-negative strains and 20% gram-positive. 88% of the strains were sensitive to PAPM and 93% to CFT but only 58% to ampicillin. The sensitivity of recurring bacteria was not influenced by the short course of PAPM or CFT. The faecal flora was influenced by the treatment with PAPM in terms of growth of Pseudomonas aeruginosa and fungi in some patients, but no resistant strains of Enterobacteriaceae were observed. The peak serum concentrations of ampicillin and mecillinam were obtained 2 hours after intake of the drug and were 4.5 micrograms/ml and 1.7 micrograms/ml respectively. The prostate tissue concentration of ampicillin and mecillinam (AM) was low.