预防性抗生素是否会降低机器人辅助激进囊切术后尿路感染的发生率? 一个随机对照试验
Ahmed A Hussein1, Abdul Wasay Mahmood1, Ali Ahmad1
1Department of Urology, Roswell Park Comprehensive Cancer Center, Buffalo, New York.
The Journal of urology
|April 25, 2025
概括
预防性抗生素显著降低了机器人辅助激进囊切除术 (RARC) 后的90天尿路感染 (UTIs) 和相关并发症. 这种方法还降低了成本,而没有增加不良事件,改善了患者的治疗结果.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 手术瘤学手术瘤学
- 传染性疾病 传染性疾病
背景情况:
- 机器人辅助激进囊切除术 (RARC) 是用于膀癌的复杂手术.
- 尿路感染 (UTI) 是RARC后的一个常见并发症.
- 优化术后护理以预防尿路感染对于患者的康复和降低医疗保健成本至关重要.
研究的目的:
- 评估延长的预防性抗生素使用在RARC后90天的尿路感染预防中的有效性.
- 评估预防性抗生素对感染并发症,再入院和RARC后成本的影响.
主要方法:
- 一个随机对照试验,比较RARC后的标准护理 (SOC) 与30天的预防性抗生素 (尼托福兰或trimethoprim/sulfamethoxazole).
- 包括接受RARC与尿路转移的患者.
- 主要终点是90天尿路感染的发生率;次要终点包括并发症,再入院和成本.
主要成果:
- 预防性抗生素组显示了0%的尿路感染率,而SOC组的25% (P = .001).
- 在抗生素组中,感染性并发症和与尿路感染相关的再入院明显较低 (分别为14%与43%和5%与30%).
- 在治疗组中,囊切除术后的平均成本减少了9074美元,治疗所需的数量为4.0,以防止一种尿路感染.
结论:
- 在RARC后30天的预防性抗生素有效预防90天的尿路感染.
- 这一策略减少了与RARC相关的传染性并发症,再入院和医疗费用.
- 预防性抗生素可以安全地在RARC后使用,而不会增加不良事件.
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