Prescott S, Hadi M A, Elton R A, Ritchie A W, Foubister G C, Gould J C, Hargreave T B
Department of Surgery/Urology, Western General Hospital, Edinburgh.
Br J Urol. 1990 Nov;66(5):509-14. doi: 10.1111/j.1464-410x.1990.tb14999.x.
Two different regimens of cephalosporin antibiotic prophylaxis were compared with antiseptic lubricating jelly to try to prevent infection and complications in 196 men after prostatic surgery. Pre-operative urine was cultured and prostatic chips (170 cases) were also cultured to define the source of any infection. The use of antibiotics was associated with a reduced risk of postoperative bacteriuria. No serious complications occurred, although 1 patient in the antiseptic treated group developed rigors; 79 of 170 patients (46%) had positive prostatic chip cultures, of whom 74 had sterile pre-operative urine. There was no association between the result of chip culture and the presence of a pre-operative catheter. Culture positive patients had an increased risk of post-operative urine infection, although the same organism was found in the prostate and urine in only 36% of cases of post-operative bacteriuria and in 43 (54%) the organism cultured from the prostate was Staphylococcus albus. This study provides further evidence of the benefit of true prophylactic antibiotic therapy for transurethral prostatic surgery and the prostatic chip data suggest that some of the risk is due to pre-operative contamination of the prostate in the absence of per-operative urinary infection or catheterisation.
对196名接受前列腺手术后的男性患者，比较了两种不同的头孢菌素抗生素预防方案与抗菌润滑凝胶预防感染及并发症的效果。术前对尿液进行培养，并对前列腺组织切片（170例）进行培养以确定感染源。使用抗生素可降低术后菌尿症的风险。虽然抗菌治疗组有1例患者出现寒战，但未发生严重并发症；170例患者中有79例（46%）前列腺组织切片培养呈阳性，其中74例术前尿液无菌。前列腺组织切片培养结果与术前是否留置导尿管无关。培养阳性患者术后发生尿液感染的风险增加，尽管在术后菌尿症病例中，仅36%的患者前列腺和尿液中发现相同病原体，且43例（54%）前列腺培养出的病原体为白色葡萄球菌。本研究进一步证明了真正的预防性抗生素治疗对经尿道前列腺手术的益处，前列腺组织切片数据表明，部分风险是由于术前前列腺污染，而术中无尿路感染或未留置导尿管。
