Spachmann Philipp J, Fischer Sophie E, Goßler Christopher, Denzinger Stefan, Burger Maximilian, Breyer Johannes, Otto Wolfgang, Schnabel Marco J, Bründl Johannes, Rosenhammer Bernd
Department of Urology, Caritas St. Josef Medical Center Regensburg, University of Regensburg, 93053 Regensburg, Germany.
Urologie Landau Isar and Urologie Plattling, 94405 Landau/Isar, 94447 Plattling, Germany.
Antibiotics (Basel). 2024 Oct 6;13(10):940. doi: 10.3390/antibiotics13100940.
Recently, the German Federal Institute for Medicines and Medical Products restricted the use of fosfomycin in transrectal biopsy of the prostate (TRBP). Accordingly, the need for other antibiotic agents for prophylaxis in TRBP is urgent since antibiotic prophylaxis is mandatory in accordance with these guidelines. After the restriction of the use of ciprofloxacin, and before the use of fosfomycin in Germany was falsely allowed, amoxicillin/clavulanic acid was evaluated as an alternative for antibiotic prophylaxis in TRBP. Regarding hospitalization for post-interventional infections, 359 patients at the Department of Urology of the University of Regensburg, at Caritas-St. Josef Medical Center as a single center, underwent TRBP between 2 July 2019 and 30 June 2020. Regarding antibiotic prophylaxis, the post-interventional hospitalization rate due to bacterial complications was relevant. Of the 359 patients, 10 (2.8%) had an infection requiring hospitalization post-TRBP. A total of 349 (97.2%) patients had no infection-related hospitalization. This corresponds to an incidence rate of only 2.8%. Referring to the previous infection rates under the now obsolete ciprofloxacin, amoxicillin/clavulanic acid can show a similar, if not tendentially even lower, risk of infection, and so this substance can be an alternative for antibiotic prophylaxis in TRBP. Another advantage is that, according to the WHO's AWaRe classification, amoxicillin/clavulanic acid is one of the so-called Access antibiotics. This study is limited as rectal swabs and urine cultures were not performed on every patient before TRBP.
最近，德国联邦药品和医疗器械研究所限制了磷霉素在经直肠前列腺活检（TRBP）中的使用。因此，由于根据这些指南预防性使用抗生素是强制性的，所以迫切需要其他抗生素用于TRBP的预防。在德国限制使用环丙沙星之后，且在错误地允许使用磷霉素之前，阿莫西林/克拉维酸被评估为TRBP抗生素预防的替代药物。关于介入后感染的住院情况，雷根斯堡大学泌尿外科、明斯特慈善圣约瑟夫医疗中心作为单一中心，在2019年7月2日至2020年6月30日期间对359例患者进行了TRBP。关于抗生素预防，细菌并发症导致的介入后住院率是相关的。在这359例患者中，10例（2.8%）在TRBP后发生了需要住院治疗的感染。共有349例（97.2%）患者没有因感染而住院。这对应的发病率仅为2.8%。参照现已淘汰的环丙沙星以前的感染率，阿莫西林/克拉维酸可显示出相似的感染风险，即使不是在趋势上更低，所以这种药物可作为TRBP抗生素预防的替代药物。另一个优点是，根据世界卫生组织的AWaRe分类，阿莫西林/克拉维酸是所谓的可及性抗生素之一。本研究存在局限性，因为在TRBP前并非对每位患者都进行了直肠拭子和尿培养。
