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[Studies on prophylaxis and therapy of pivmecillinam against post-prostatectomy urinary tract infection]
Abstract:
Patients received pivmecillinam (PMPC) after prophylactic use of various antimicrobial chemotherapeutic agents following prostatectomy, and their clinical responses were assessed for effectiveness in the treatment and prevention of postoperative infection. The data were also analyzed to explore the relationship between bacterial isolates obtained during the postoperative course and the antimicrobial agents administered prophylactically against postoperative infection. Therapeutic effect of PMPC: Treatment of postoperative infections with PMPC was effective in 36 (53.7%) out of 67 patients who had undergone prostatectomy. Prophylactic effect of PMPC: The use of PMPC provided effective prevention of infection in 22 (64.7%) out of 34 patients from whom no bacterial pathogen had been isolated before postoperative antimicrobial chemotherapy. Therapeutic responses to PMPC, compared between different types of operative procedure: There was little or no difference in therapeutic effectiveness of PMPC against postoperative infection when compared between two types of operative procedure, transurethral prostatectomy and subcapsular removal of the prostate. Incidence and types of bacterial isolates following prophylactic chemotherapy with various agents after prostatectomy: Possibly because cephapirin (CEPR) and ticarcillin (TIPC) were mainly administered, alone or in combination, for prophylaxis against postoperative infection, Serratia and Pseudomonas were most frequently isolated. The findings offer suggestions as to the appropriate combination of antimicrobial agents to be used for prophylactic purposes. Effectiveness of PMPC in the presence or absence of a preoperative indwelling urethral catheter: The use of PMPC was more effective both in the treatment and prevention of postoperative infection in cases without preoperative indwelling urethral catheterization than in those with it.
Insights
Pivmecillinam (PMPC) effectively treated 53.7% of prostatectomy patients with postoperative infections and prevented infection in 64.7% of patients. Its effectiveness was reduced by preoperative indwelling urethral catheters.
Area of Science:
- Urology
- Infectious Diseases
- Pharmacology
Context:
- Postoperative infections following prostatectomy pose significant risks.
- Antimicrobial prophylaxis is standard practice to mitigate these risks.
- Understanding the efficacy of specific agents like pivmecillinam is crucial.
Purpose:
- To assess the therapeutic and prophylactic effectiveness of pivmecillinam (PMPC) in prostatectomy patients.
- To analyze the relationship between prophylactic antimicrobial agents and postoperative bacterial isolates.
- To evaluate PMPC's efficacy based on operative procedure and catheterization status.
Summary:
- Pivmecillinam (PMPC) demonstrated therapeutic effectiveness in 53.7% of patients treated for postoperative infections post-prostatectomy.
- PMPC provided effective infection prevention in 64.7% of patients.
- Effectiveness was comparable between transurethral and subcapsular prostatectomy procedures.
- Serratia and Pseudomonas were frequently isolated, potentially linked to cephapirin and ticarcillin prophylaxis.
- PMPC was more effective in patients without preoperative indwelling urethral catheters.
Impact:
- Provides insights into the clinical utility of pivmecillinam for prostatectomy-related infections.
- Informs antimicrobial prophylaxis strategies, suggesting potential agent combinations.
- Highlights the influence of urinary catheterization on antibiotic effectiveness in this context.