Kim Dae Hyun, Bae Sang Rak, Choi Woo Suk, Park Hyoung Keun, Paick Sung Hyun, Kim Hyeong Gon, Loh Yong Soo
Departement of Urology, Konkuk University Medical Center, Seoul, Korea.
Departement of Urology, The Catholic University of Korea, Uijeongbu St. Mary's Hospital, Uijeongbu, Korea.
Korean J Urol. 2014 Sep;55(9):593-8. doi: 10.4111/kju.2014.55.9.593. Epub 2014 Sep 5.
Transrectal ultrasonography-guided prostate biopsy (TRUS-Bx) is an essential procedure for diagnosing prostate cancer. The American Urological Association (AUA) Guideline recommends fluoroquinolone alone for 1 day during TRUS-Bx. However, this recommendation may not be appropriate in regions where the prevalence of quinolone-resistant Escherichia coli is high. We investigated the real practice of antibiotic prophylaxis for TRUS-Bx in Korea.
A total of 77 hospitals performing TRUS-Bx were identified and an e-mail was sent to the Urology Department of those hospitals. The questions in the e-mail included the choice of antibiotics before and after the procedure and the duration of antibiotic therapy after TRUS-Bx.
A total of 54 hospitals (70.0%) responded to the e-mail. Before TRUS-Bx, all hospitals administered intravenous antibiotic prophylaxis. The percentage of hospitals that used quinolone, cephalosporin, and aminoglycoside alone was 48.1%, 20.4%, and 9.3%, respectively. The percentage of hospitals that used two or more antibiotics was 22.2%. After biopsy, all 54 hospitals prescribed oral antibiotics. The percentage of hospitals that prescribed quinolone alone, cephalosporin alone, or a combination of two or more antibiotics was 77.8%, 20.4%, and 1.8%, respectively. The duration of antibiotic use was more than 3 days in most hospitals (79.6%). Only four hospitals (7.4%) followed the AUA recommendation of a 1-day regimen.
The AUA recommendation was not followed by most hospitals in Korea. This clinical behavior might reflect the high quinolone resistance rate in Korea, and further studies on the most efficient prophylactic antibiotics after TRUS-Bx in Korea are warranted.
经直肠超声引导下前列腺穿刺活检（TRUS - Bx）是诊断前列腺癌的重要检查。美国泌尿外科学会（AUA）指南建议在TRUS - Bx期间仅使用氟喹诺酮类药物1天。然而，在喹诺酮耐药大肠杆菌流行率较高的地区，这一建议可能并不合适。我们调查了韩国TRUS - Bx抗生素预防的实际应用情况。
共确定了77家进行TRUS - Bx的医院，并向这些医院的泌尿外科发送电子邮件。邮件中的问题包括术前和术后抗生素的选择以及TRUS - Bx后抗生素治疗的持续时间。
共有54家医院（70.0%）回复了邮件。在TRUS - Bx之前，所有医院均进行静脉抗生素预防。单独使用喹诺酮类、头孢菌素类和氨基糖苷类药物的医院比例分别为48.1%、20.4%和9.3%。使用两种或更多种抗生素的医院比例为22.2%。活检后，所有54家医院均开具口服抗生素。单独开具喹诺酮类、单独开具头孢菌素类或两种或更多种抗生素联合使用的医院比例分别为77.8%、20.4%和1.8%。大多数医院（79.6%）的抗生素使用时间超过3天。只有四家医院（7.4%）遵循了AUA推荐的1天疗程。
韩国大多数医院未遵循AUA的建议。这种临床行为可能反映了韩国较高的喹诺酮耐药率，因此有必要对韩国TRUS - Bx后最有效的预防性抗生素进行进一步研究。
