Samarinas Michael, Skriapas Konstantinos, Mitsogiannis Iraklis, Gravas Stavros, Karatzas Anastasios, Tzortzis Vasileios
General Hospital of Larissa, Department of Urology, Larissa, Greece.
National and Kapodistrian University of Athens, Sismanoglio Hospital, 2 Department of Urology, Marousi, Greece.
Cent European J Urol. 2020;73(4):544-550. doi: 10.5173/ceju.2020.0072. Epub 2020 Oct 10.
Urinary tract infections may be a severe complication after prostate biopsy. The aim of our study is to investigate the efficacy of cefixime versus prulifloxacin, as a prophylactic treatment in the era of fluoroquinolone resistance.
In this prospective randomized trial, patients were allocated into two groups. In Group A, patients received cefixime 400 mg p.o./day, while in Group B, prulifoxacin 600 mg p.o./day, both for three days, starting the day before procedure. Eligible for the study were men with a high prostate-specific antigen (PSA) and/or a positive rectal examination. Exclusion criteria were allergy to cefixime or fluoroquinolones, low glomerular filtration rate and drug-resistance to these antibiotics. Patients were followed-up for seven days.
Finally, 120 patients were divided into 2 groups of 60 patients with a mean age of 68.6 years. A total of 16 (13.3%) men had already undergone another biopsy in the past, while 18 (15%) had received prulifloxacin and 8 (6.67%) cefixime, at least once in the last three months. During follow-up, hospital admission due to a severe urinary tract infection (UTI) was required in 2 of 60 (1.3%) and 1 of 60 (1.67%) patients from Group B and A respectively. The bacterial specimens detected in those urine cultures were resistant to prulifloxacin or cefixime. Among the remaining 117 patients (97.5%), nobody presented with a UTI.
Prophylactic cefixime could be suggested as effective in preventing severe UTIs after prostate biopsy in the era of high bacterial resistance to fluoroquinolones.
尿路感染可能是前列腺活检后的严重并发症。我们研究的目的是在氟喹诺酮耐药时代，研究头孢克肟与普卢利沙星作为预防性治疗的疗效。
在这项前瞻性随机试验中，患者被分为两组。A组患者口服头孢克肟400毫克/天，B组患者口服普卢利沙星600毫克/天，均服用三天，从手术前一天开始。符合研究条件的是前列腺特异性抗原（PSA）高和/或直肠检查阳性的男性。排除标准为对头孢克肟或氟喹诺酮过敏、肾小球滤过率低以及对这些抗生素耐药。对患者进行了七天的随访。
最后，120名患者被分为两组，每组60名，平均年龄为68.6岁。共有16名（13.3%）男性过去曾接受过另一次活检，而在过去三个月中，分别有18名（15%）接受过普卢利沙星治疗，8名（6.67%）接受过头孢克肟治疗。在随访期间，B组和A组分别有2名（1.3%）和1名（1.67%）患者因严重尿路感染（UTI）需要住院治疗。在那些尿培养中检测到的细菌标本对普卢利沙星或头孢克肟耐药。在其余117名患者（97.5%）中，没有人出现尿路感染。
在对氟喹诺酮类细菌耐药性高的时代，预防性使用头孢克肟可有效预防前列腺活检后严重尿路感染。
