单独使用伊塞帕米辛作为跨直肠前列腺针活检的抗菌预防:"我们还需要勒沃素吗?"
Hiroki Yamada1, Kojiro Tashiro1, Yusuke Takahashi1
1Department of Urology, The Jikei University Katsushika Medical Center, 6-41-2 Aoto, Katsushika-ku, Tokyo, 125-8506, Japan.
概括
对于前列腺活检来说,常规的勒沃素 (LVFX) 可能是不必要的. 一项研究发现,仅静脉注射伊塞帕米辛有效地预防了感染,即使在高风险患者中也是如此,这表明可以优化抗生素的使用.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- 增加抗levfloxacin (LVFX) 的大肠杆菌需要评估通过直肠超声波引导的前列腺针活检 (TRP-Bx) 的抗生素预防.
- 优化抗生素的使用对于打击耐药性和改善患者的治疗结果至关重要.
研究的目的:
- 确定是否需要常规的预防性勒沃素 (LVFX) 进行跨直肠超声波导向的前列腺针活检 (TRP-Bx).
- 评估静脉注射伊塞帕米辛 (ISP) 单独与联合LVFX和ISP在预防TRP-Bx相关感染方面的疗效.
主要方法:
- 一项对636名接受TRP-Bx的患者进行的比较研究,分为两组:第一组 (口服LVFX + IV ISP) 和第二组 (仅IV ISP).
- 包括一个高风险小组,其中包括前列腺扩大,失尿症,糖尿病或类固醇使用等因素.
- 活检后监测发烧性泌尿道感染 (fGUTIs).
主要成果:
- 两组之间fGUTI率没有显著差异 (0.3%对0.6%).
- 发烧性泌尿道感染 (fGUTIs) 仅发生在所有患者的0.5%.
- 仅静脉注射伊塞帕米辛 (ISP) 在低风险和高风险患者中有效预防fGUTIs.
结论:
- 单剂量静脉注射伊塞帕米辛 (ISP) 400毫克似乎足以预防与TRP-Bx相关的fGUTIs.
- 常规的levofloxacin (LVFX) 预防可能是不必要的,支持在前列腺活检程序中更明智的抗生素使用.
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