Department of Urology, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
J Urol. 2013 Jul;190(1):113-7. doi: 10.1016/j.juro.2013.01.015. Epub 2013 Jan 9.
In April 2008 InhibiZone® antibiotic coated artificial urinary sphincters were introduced. The antibiotic coating significantly increased the cost of the device by an average of $1,300 per artificial urinary sphincter. To our knowledge, no clinical data to date support the theory that this antibiotic coating decreases the risk of artificial urinary sphincter infection. Therefore, we compared infection rates in our cases before and after the introduction of InhibiZone coated artificial urinary sphincters to determine whether the coating decreased the device infection rate.
We retrospectively reviewed the records of 426 consecutive patients in whom an artificial urinary sphincter was implanted by a single surgeon from January 2005 to June 2012. Patients were divided equally into 213 consecutive males who received an artificial urinary sphincter without the antibiotic coating from January 2005 to March 2008 and 213 consecutive males implanted with the antibiotic coated artificial urinary sphincter from April 2008 to June 2012. Demographics and infection rates were compared.
Patient mean age, associated comorbidities and complexity were almost identical in the groups with and without the antibiotic coating, and infection rates were identical at 7 patients (3.3%) per group (p = 0.99). In the more complex patient subgroup with revision the antibiotic coating did not impact the infection rate. Infection developed in 2 of 50 patients (5%) with the antibiotic coated device and in 3 of 38 (6%) with the uncoated device (p = 0.42).
The InhibiZone coating of the artificial urinary sphincters did not alter the infection rate in our study. The added cost of the antibiotic coated artificial urinary sphincters (total of approximately $276,000 more for all 213 coated devices) was of no benefit in our series. Based on this assessment, we will transition to using artificial urinary sphincters without InhibiZone in our practice.
2008 年 4 月，InhibiZone®抗生素涂层人工尿失禁装置问世。抗生素涂层使设备的平均成本增加了 1300 美元。据我们所知，目前尚无临床数据支持抗生素涂层可降低人工尿失禁装置感染风险的理论。因此，我们比较了引入 InhibiZone 涂层人工尿失禁装置前后我们病例中的感染率，以确定该涂层是否降低了设备的感染率。
我们回顾性地分析了一位外科医生在 2005 年 1 月至 2012 年 6 月期间对 426 例连续患者植入人工尿失禁装置的记录。患者分为两组，每组 213 例，连续男性患者分别于 2005 年 1 月至 2008 年 3 月接受无抗生素涂层的人工尿失禁装置，2008 年 4 月至 2012 年 6 月接受抗生素涂层人工尿失禁装置。比较了两组患者的人口统计学数据和感染率。
两组患者的平均年龄、合并症和复杂性几乎相同，感染率也相同，每组各有 7 例（3.3%）（p=0.99）。在更为复杂的接受翻修手术的患者亚组中，抗生素涂层并未影响感染率。在 50 例接受抗生素涂层装置的患者中，有 2 例（5%）发生感染，而在 38 例未涂层装置的患者中，有 3 例（6%）发生感染（p=0.42）。
在我们的研究中，InhibiZone 涂层人工尿失禁装置并未改变感染率。抗生素涂层人工尿失禁装置（所有 213 个涂层装置共增加约 276000 美元）的额外成本在我们的系列研究中没有任何益处。基于这种评估，我们将在实践中过渡使用无 InhibiZone 的人工尿失禁装置。
