Wallner K, Roy J, Harrison L
Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
Int J Radiat Oncol Biol Phys. 1996 Oct 1;36(3):681-3. doi: 10.1016/s0360-3016(96)00296-9.
To determine the incidence of postimplant infection in patients who are not given prophylactic antibiotics (ATBs).
One hundred thirty-one patients had computerized tomography (CT)-planned transperineal 125I implantation of the prostate from 1988 through 1995. One hundred fourteen of the patients did not receive prophylactic ATBs, 19 of whom required postimplant Foley catheter drainage for 1 day or more for acute urinary retention.
The incidence of postimplant febrile episodes within 2 weeks of surgery among the patients who had not received prophylactic ATBs was 2 of 114 (2%). One of the two patients who developed postimplantation febrile episodes was treated successfully with ATBs as an outpatient. The second patient, who had a history of chronic lymphocytic leukemia (CLL) and immune suppression, developed E. coli sepsis and required intravenous antibiotics. Of 17 patients who received prophylactic ATBs, none had a postoperative febrile episode.
We continue to refrain from routinely prescribing prophylactic ATBs unless there is some compelling circumstance including rheumatic heart disease, prosthetic devices, immune compromise, or a previous history of prostatitis.
确定未接受预防性抗生素治疗的患者植入术后感染的发生率。
1988年至1995年期间，131例患者接受了计算机断层扫描（CT）引导下经会阴125I前列腺植入术。其中114例患者未接受预防性抗生素治疗，其中19例因急性尿潴留需要在植入术后留置Foley导尿管引流1天或更长时间。
未接受预防性抗生素治疗的患者术后2周内发热发作的发生率为114例中的2例（2%）。发生植入术后发热发作的2例患者中，1例作为门诊患者接受抗生素治疗成功。第二例患者有慢性淋巴细胞白血病（CLL）病史且免疫抑制，发生大肠杆菌败血症，需要静脉使用抗生素。在17例接受预防性抗生素治疗的患者中，无一例术后发热发作。
我们继续不常规开具预防性抗生素，除非存在一些紧迫情况，包括风湿性心脏病、假体装置、免疫功能低下或既往前列腺炎病史。
