Kisa Erdem, Altug Mustafa Ugur, Gurbuz Oguz Alp, Ozdemir Harun
Department of Urology, Tepecik Education and Research Hospital, Izmir, Turkey.
Department of Urology, Acibadem University School of Medicine, Istanbul, Turkey.
Int Braz J Urol. 2017 Nov-Dec;43(6):1068-1074. doi: 10.1590/S1677-5538.IBJU.2016.0619.
To determine the risk factors and the efficiency of rectal swab samples to prevent infectious complications in prostate biopsy, and compare fosfomycin with ciprofloxacin use in prophylaxis.
Between May and October 2014, pre-biopsy risk factors and their effect in ciprofloxacin and fosfomycin prophylaxis were determined. Pre-biopsy urinalysis, urine culture and rectal swab samples were obtained from all of the patients. Rectal swabs were obtained upon admission, and biopsy was performed in the following 3-7 days. The place of rectal swab samples and efficiency of fosfomycin use was evaluated.
Pre-biopsy rectal swabs were obtained from 110 patients who revealed 60.9% fluoroquinolone resistance (FQR), and 32.7% fluoroquinolone sensitivity (FQS). Fosfomycin resistance was present in 3 patients. Ciprofloxacin use in last 6 months was the only risk factor for FQR. Antibiotic prophylaxis was given to both groups with and without risk factors, according to swab results, and no infective complications were observed. Among the group where fosfomycin was used empirically, one patient had an infection needing hospitalization, however this constitutes no statistical difference between the Group that fosfomycin used empirically or according to swab results (p=0.164).
In prostate biopsy prophylaxis, ciprofloxacin may be used liberally in patients without risk factors, but it should be given according to the rectal swab results in the patients with risk, and fosfomycin may be used independently of risk factors and rectal swab results.
确定直肠拭子样本在预防前列腺活检感染并发症方面的危险因素和有效性，并比较磷霉素与环丙沙星在预防中的应用。
2014年5月至10月期间，确定活检前危险因素及其在环丙沙星和磷霉素预防中的作用。从所有患者中获取活检前尿液分析、尿培养和直肠拭子样本。入院时采集直肠拭子，在接下来的3 - 7天内进行活检。评估直肠拭子样本的部位和磷霉素使用的有效性。
从110例患者中获取活检前直肠拭子，其中60.9%显示氟喹诺酮耐药（FQR），32.7%显示氟喹诺酮敏感（FQS）。3例患者存在磷霉素耐药。过去6个月内使用环丙沙星是FQR的唯一危险因素。根据拭子结果，对有和无危险因素的两组患者均给予抗生素预防，未观察到感染并发症。在经验性使用磷霉素的组中，有1例患者感染需要住院治疗，但这在经验性使用磷霉素组和根据拭子结果使用磷霉素组之间无统计学差异（p = 0.164）。
在前列腺活检预防中，无危险因素的患者可自由使用环丙沙星，但有危险因素的患者应根据直肠拭子结果给药，磷霉素可独立于危险因素和直肠拭子结果使用。
