基于直肠片的向预防性抗生素减少了跨直肠前列腺活检后的传染性并发症:随机对照试验的系统审查和元分析
Ichiro Tsuboi1,2,3, Mehdi Kardoust Parizi1,4, Akihiro Matsukawa1,5
1Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
European urology open science
|October 9, 2025
概括
针对性预防性抗生素 (TPA) 基于直肠拭子显著减少发烧性尿路感染 (fUTIs) 后跨直肠超声指导前列腺活检 (TRUS-PB). 与标准抗生素相比,这种方法可以将FUTI的发病率降低一半,尽管败血症风险需要进一步研究.
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
- 在瘤学瘤学.
背景情况:
- 跨直肠超声导向前列腺活检 (TRUS-PB) 广泛用于前列腺癌 (PCa) 诊断.
- TRUS-PB与感染并发症的显著风险有关.
- 通过超声波引导的前列腺活检是推的指导方法.
研究的目的:
- 评估针对性预防性抗生素 (TPAs) 的疗效,基于直肠拭子培养.
- 在TRUS-PB后减少感染并发症方面,将TPA与实证预防性抗生素进行比较.
主要方法:
- 进行了随机对照试验 (RCT) 的系统审查和元分析.
- 在2024年12月搜索了PubMed,科学网和Scopus数据库.
- 主要结局包括发烧性尿路感染 (fUTI) 和败血症发病率.
主要成果:
- 分析了9个涉及3002名患者的RCT.
- TPAs将fUTI发病率降低了大约一半 (2.7%与5.2%,RR:0.54,p=0.003).
- 两组之间没有观察到血发病率的统计学上显著差异 (1.3%对1.8%,RR:0.74,p=0.4).
结论:
- 在TRUS-PB后,基于直肠拭子培养的TPA显著降低了fUTI发病率.
- 没有足够的证据来评估TPAs对败血症风险的影响.
- 对于接受TRUS-PB的患者,由于FUTI发病率降低,建议使用以直肠拭子为基础的TPA.
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