甲氧苄啶-磺胺甲恶唑与奈替米星-甲硝唑预防性用于经直肠前列腺活检的随机对照研究

A randomized comparative study of the prophylactic use of trimethoprim-sulfamethoxazole versus netilmycin-metronidazole in transrectal prostatic biopsy.

作者信息

Fong I W, Struthers N, Honey R J, Simbul M, Boisseau D A

机构信息

Department of Medicine, St. Michael's Hospital, University of Toronto, Ontario, Canada.

出版信息

J Urol. 1991 Sep;146(3):794-7. doi: 10.1016/s0022-5347(17)37923-5.

DOI:10.1016/s0022-5347(17)37923-5

PMID:1908529

Abstract

An open randomized study was done to compare the prophylactic value of single doses of netilmycin-metronidazole versus trimethoprim-sulfamethoxazole in the prevention of postoperative infections associated with transrectal prostatic biopsy. Of 117 patients enrolled in the study 101 were evaluated and of these patients 47 received netilmycin-metronidazole and 54 received trimethoprim-sulfamethoxazole. The bacteremia rate in the netilmycin-metronidazole group was 28% (13 of 47 patients) with a 95% confidence interval of 18 to 42% and in the trimethoprim-sulfamethoxazole group it was 37% (20 of 54) with a confidence interval of 26 to 50% (p = 0.43). None of the patients with bacteremia was symptomatic. Urinary tract infection rates were greater in the netilmycin-metronidazole group: 17% (8 of 47 patients) versus 2% (1 of 54) in the trimethoprim-sulfamethoxazole group, p = 0.01. Trimethoprim-sulfamethoxazole (cotrimoxazole) is a better choice as an antimicrobial prophylaxis for patients undergoing transrectal prostatic biopsy.

摘要

进行了一项开放性随机研究，以比较单剂量奈替米星-甲硝唑与甲氧苄啶-磺胺甲恶唑在预防经直肠前列腺活检术后感染方面的预防价值。在该研究纳入的117例患者中，对101例进行了评估，其中47例接受了奈替米星-甲硝唑治疗，54例接受了甲氧苄啶-磺胺甲恶唑治疗。奈替米星-甲硝唑组的菌血症发生率为28%（47例患者中的13例），95%置信区间为18%至42%；甲氧苄啶-磺胺甲恶唑组的菌血症发生率为37%（54例中的20例），置信区间为26%至50%（p = 0.43）。所有菌血症患者均无症状。奈替米星-甲硝唑组的尿路感染发生率更高：为17%（47例患者中的8例），而甲氧苄啶-磺胺甲恶唑组为2%（54例中的1例），p = 0.01。对于接受经直肠前列腺活检的患者，甲氧苄啶-磺胺甲恶唑（复方新诺明）作为抗菌预防用药是更好的选择。