The effectiveness of a short perioperative course with pivampicillin/pivmecillinam in transurethral prostatic resection: clinical results

In a randomized control study comprising 261 patients undergoing transurethral prostatic resection (TUR), the effect of a short perioperative course with the oral combination of pivampicillin/pivmecillinam (PAPM) was analysed in 129 patients. The study was divided in 2 parts: the first 60 patients received 450 mg and the following 69 patients, 900 mg every 12 h until removal of catheter but not longer than for 1 week. 132 controls received parenterally 1 g of cefotaxime (CFT) daily throughout the study. During the first part of the study the frequency of bacteriuria in the PAPM group was 43% preoperatively and 30% 10 days postoperatively, during the second part 47% and 12%, respectively (p less than 0.025). In the CFT group the frequency of bacteriuria was reduced from 52% preoperatively to 28% postoperatively. The prophylactic effect (i.e. the protection against acquired bacteriuria) was 96% and 92% in the PAPM and the CFT groups, respectively. Preoperative bacteriuria was eliminated in 40% of the patients during first part and 69% during second part in the PAPM group, while corresponding figures were 48% and 46% in the cefotaxime group. There were 2 cases of septicemia and 5 of upper urinary tract infections throughout the study evenly distributed between the two groups. Oral pivampicillin/pivmecillinam 900 mg every 12 h was found to be a good alternative for perioperative antibiotic prophylaxis at TUR.