门诊囊镜中的抗生素预防:即使在高风险患者中也挑战其作用-前性观察研究
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
概括
抗生素预防没有显著降低尿路感染 (UTI) 后的频率. 对低风险患者来说,常规抗生素使用可能是不必要的,支持抗生素管理. 需要进一步的研究来更新指南.
科学领域:
- 尿道病学
- 传染性疾病
- 药理学
背景情况:
- 囊镜检查是一种常见的泌尿器科手术,具有术后尿路感染 (UTI) 的风险.
- 高危患者,包括患有糖尿病,慢性阻塞性肺病 (COPD) 或免疫缺陷患者,面临尿道感染的风险较高.
- 抗生素预防预防这些感染的有效性仍然令人担忧.
研究的目的:
- 评估抗生素预防在柔性囊镜后预防尿道感染的有效性.
- 确定常规抗生素使用是否有助于减少手术后尿路感染的发生率.
主要方法:
- 一项前性观察性研究招募了300名接受门诊灵活囊镜的成年患者.
- 患者被分为两组:一组接受抗生素预防,一组不接受.
- 主要结论是4周内尿路感染的发生率,通过尿液培养和临床症状或事件来定义.
主要成果:
- 在抗生素预防组中,尿路感染发病率为9. 3%,在不预防组中为10. 0%.
- 在两组患者之间没有观察到尿路感染率的统计学显著差异 (p=0. 510).
- 没有报告尿道败血症病例,风险因素均分布.
结论:
- 在本研究中,抗生素预防并没有显著降低囊镜后的尿路感染率.
- 在接受囊镜检查的低风险患者中,可能不需要常规的预防性抗生素.
- 这些发现支持抗生素管理原则,并强调需要进一步进行大规模研究以完善临床指南.
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