Lokeshwar Soum D, Bitran Joshua, Madhusoodanan Vinayak, Kava Bruce, Ramasamy Ranjith
Department of Urology, University of Miami Miller School of Medicine, 1120 NW 14th Street, 15th Floor, Miami, FL, 33136, USA.
Curr Urol Rep. 2019 Jan 30;20(2):11. doi: 10.1007/s11934-019-0874-8.
Inflatable penile prosthesis (IPP) is a treatment for erectile dysfunction. IPPs have undergone improvements; however, post-surgical infections still occur. Furthermore, the type of pathogens infecting the implants has changed recently from Gram-positive to Gram-negative bacteria and fungi due to advances in antibiotic dips targeting the skin flora. To protect against infection, the AMS 700 is pre-coated with InhibiZone (mixture of Rifampin/Minocycline) and the Coloplast Titan, with several antibiotic dip options of differing efficacies. This review discusses strategies to decrease the infection rates in implant surgery, focusing on antibiotic dips.
Current research endorses the use of rifampin/gentamicin as the most studied combination; however, some studies have utilized different dips for additional coverage including the InhibiZone on the AMS 700. With the increasing prevalence of diabetes and Gram-negative organisms, there is a need to develop strategies for increased coverage against infections. Controlled studies with different antibiotic combinations are needed to identify the ideal cocktail to decrease infection.
可膨胀阴茎假体(IPP)是治疗勃起功能障碍的一种方法。IPP已有所改进;然而,术后感染仍会发生。此外,由于针对皮肤菌群的抗生素浸渍技术的进步,感染植入物的病原体类型最近已从革兰氏阳性菌转变为革兰氏阴性菌和真菌。为预防感染,AMS 700预先涂有InhibiZone(利福平/米诺环素混合物),而柯洛普拉斯泰坦(Coloplast Titan)有几种不同疗效的抗生素浸渍选择。本综述讨论了降低植入手术感染率的策略,重点是抗生素浸渍。
目前的研究支持使用利福平/庆大霉素,这是研究最多的组合;然而,一些研究使用了不同的浸渍剂以提供额外的覆盖范围,包括AMS 700上的InhibiZone。随着糖尿病和革兰氏阴性菌感染率的不断上升,需要制定策略以增加对感染的覆盖范围。需要进行不同抗生素组合的对照研究,以确定降低感染的理想组合。