급성전립선염 환자에서 이전 술기 유무에 따른 임상적 고찰
Clinical Study According to Presence of Prior Manipulation in Patients with Acute Bacterial Prostatitis
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Purpose: Acute bacterial prostatitis (ABP) is uncommon and proper guidelines concerning antibiotic administration for ABP with urologic procedure are unclear. We retrospectively analyzed clinical symptoms and etiologic organism in ABP according to presence of prior urologic manipulation. Materials and Methods: The clinical records of 65 patients who had been treated for ABP between January 2007 and December 2011 were reviewed. We analyzed parameters including history taking, physical examination, prior manipulations, antibiotics administration, mean length of treatment, complications,urinalysis, and urine and blood culture. Results were analyzed according to two subgroups; Group 1, those without prior urologic manipulation, and Group 2, those with prior manipulation. Results: The population of Group 1 was 22 (33.8%) and Group 2 was 43 (66.2%). The mean age of the patients in both groups were 56.5±15.6 years and 64.0±12.5 years, respectively. Of the clinical symptoms in both groups, fever was most common (81.8% and 83.7%). The mean pyuria grades were 2.82±0.37 and 3.47±0.25each in both groups. In group 2, prostatic biopsy (36, 83.7%) was the most frequent manipulation of the patients. Dysuria and storage symptoms were significantly more frequent in Group 1. The number of diabetes mellitus patients and the admission rates were higher in Group 2. E. coli was the most frequently isolated pathogen from urine and blood (23.1% and 24.6%, respectively). Resistance to ciprofloxacin was very high in group 1 (60.0%) and group 2 (83.3%). However, there was no significant difference between the two groups. Conclusions: Resistance rates to ampicillin and ciprofloxacin in ABP were very high in all patients. The resistance rates were higher in patients with prior manipulation, but there was no significant difference. When we consider high resistance to ciprofloxacin in ABP, more careful attention should be paid to empirical treatment of ABP patients with prior manipulation.
Abstract
Purpose: Acute bacterial prostatitis (ABP) is uncommon and proper guidelines concerning antibiotic administration for ABP with urologic procedure are unclear. We retrospectively analyzed clinical symptoms and etiologic organism in ABP according to presence of prior urologic manipulation. Materials and Methods: The clinical records of 65 patients who had been treated for ABP between January 2007 and December 2011 were reviewed. We analyzed parameters including history taking, physical examination, prior manipulations, antibiotics administration, mean length of treatment, complications,urinalysis, and urine and blood culture. Results were analyzed according to two subgroups; Group 1, those without prior urologic manipulation, and Group 2, those with prior manipulation. Results: The population of Group 1 was 22 (33.8%) and Group 2 was 43 (66.2%). The mean age of the patients in both groups were 56.5±15.6 years and 64.0±12.5 years, respectively. Of the clinical symptoms in both groups, fever was most common (81.8% and 83.7%). The mean pyuria grades were 2.82±0.37 and 3.47±0.25each in both groups. In group 2, prostatic biopsy (36, 83.7%) was the most frequent manipulation of the patients. Dysuria and storage symptoms were significantly more frequent in Group 1. The number of diabetes mellitus patients and the admission rates were higher in Group 2. E. coli was the most frequently isolated pathogen from urine and blood (23.1% and 24.6%, respectively). Resistance to ciprofloxacin was very high in group 1 (60.0%) and group 2 (83.3%). However, there was no significant difference between the two groups. Conclusions: Resistance rates to ampicillin and ciprofloxacin in ABP were very high in all patients. The resistance rates were higher in patients with prior manipulation, but there was no significant difference. When we consider high resistance to ciprofloxacin in ABP, more careful attention should be paid to empirical treatment of ABP patients with prior manipulation.
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