アムブラトリー・シストスコピーにおける抗生物質の予防:高リスク患者でもその役割に疑問を呈する見通しの観察研究
Dolev Perez1, Ariel Mamber2, Michael Pasherstnik2
1Department of Urology, Shaare Zedek Medical Center, Jerusalem, Israel. drdolevperez@gmail.com.
Investigative and clinical urology
|September 2, 2025
まとめ
抗生物質の予防は,膀検査後の尿路感染症 (UTI) の発生率を有意に低下させなかった. 定期的な抗生物質の使用は,低リスクの患者では不要であり,抗生物質管理を支援します. ガイドラインを更新するにはさらなる研究が必要です.
科学分野:
- 泌尿器科
- 感染症
- 薬理学について
背景:
- 膀鏡検査は,尿路感染症の危険性のある一般的な泌尿器科手術である.
- 糖尿病,慢性閉塞性肺疾患 (COPD) または免疫不全の患者を含む高リスク患者は,尿路感染症のリスクが高くなります.
- これらの感染を予防する抗生物質の有効性は依然として懸念されています.
研究 の 目的:
- 柔軟なシストスコピーの後の尿路感染症の予防における抗生物質予防の有効性を評価する.
- 処置後のUTIの発生率を減らすのに有益であるかどうかを判断する.
主な方法:
- 展望的観察研究では,300人の成人患者が ambulatory flexible cystoscopy を受けました.
- 患者は2つのコホートに分けられ,1つは抗生物質の予防療法を受け,1つは受けなかった.
- 尿培養と臨床症状またはイベントによって定義された4週間のUTIの発生率でした.
主要な成果:
- UTIの発生率は,抗生物質予防群では9. 3%,予防群では10. 0%でした.
- 2つのコホート (p=0. 510) の間で,尿路感染症の発生率に統計的に有意な差は認められなかった.
- 尿道性敗血症の症例は報告されず,リスク因子は均等に分布していた.
結論:
- この研究では,抗生物質の予防により,シストスコピーの後の尿路感染症の発生率が有意に低下しなかった.
- 定期的な予防抗生物質の使用は,シストスコピーを受ける低リスクの患者には必要ない場合があります.
- 研究結果は,抗生物質管理の原則を支持し,臨床ガイドラインを洗練するためにさらなる大規模な研究が必要であることを強調しています.
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