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Optimal Modified Extended Antibiotic Prophylaxis for Prostate Biopsy: The Addition of Two Intravenous Doses of Amikacin to Ciprofloxacin

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초록

Purpose: This retrospective study was undertaken to investigate whether increasing amikacin dosage for ciprofloxacin prophylaxis in patients with fluoroquinolone (FQ)-resistant rectal flora reduce infectious complications after transrectal ultrasound-guided prostate biopsy (TRUSPB).Materials and Methods: A total of 430 patients with FQ-resistant rectal flora based on rectal swab cultures were divided into two groups. Patients in both groups were administered ciprofloxacin (400 mg, intravenous [IV], twice daily) on the same day as TRUSPB and one day after biopsy. However, whereas group 1 patients (n=202) were administered a single injection of amikacin (1 g, IV) one hour before TRUSPB, patients in group 2 (n=228) were administered two injections of amikacin (1 g, IV) before one hour TRUSPB and again on the day after TRUSPB.Results: Of the 430 study subjects, 129 (30.0%) showed extended-spectrum beta-lactamase (ESBL) positivity. The overall incidence rate of infectious complications was 2.8% (12/430). Infectious complication rates were 4.0% (8/202) in group 1 and 1.3% (3/228) in group 2 (p=0.075). Urinary tract infection and acute prostatitis were more frequent in group 1 (3.5% vs. 0.4%, p=0.029). Infectious complication rates in ESBL negative patients were 3.4% (5/145) in group 1 and 1.3% (2/156) in group 2, whereas those in ESBL positive patients were 7.0% (4/57) in group 1 and 1.4% (1/72) in group 2.Conclusions: Increasing the dosage of amikacin for ciprofloxacin prophylaxis reduce infectious complications in patients with FQ-resistant rectal flora and to be more effective in ESBL positive patients with FQ-resistant rectal flora.

Abstract

Purpose: This retrospective study was undertaken to investigate whether increasing amikacin dosage for ciprofloxacin prophylaxis in patients with fluoroquinolone (FQ)-resistant rectal flora reduce infectious complications after transrectal ultrasound-guided prostate biopsy (TRUSPB).Materials and Methods: A total of 430 patients with FQ-resistant rectal flora based on rectal swab cultures were divided into two groups. Patients in both groups were administered ciprofloxacin (400 mg, intravenous [IV], twice daily) on the same day as TRUSPB and one day after biopsy. However, whereas group 1 patients (n=202) were administered a single injection of amikacin (1 g, IV) one hour before TRUSPB, patients in group 2 (n=228) were administered two injections of amikacin (1 g, IV) before one hour TRUSPB and again on the day after TRUSPB.Results: Of the 430 study subjects, 129 (30.0%) showed extended-spectrum beta-lactamase (ESBL) positivity. The overall incidence rate of infectious complications was 2.8% (12/430). Infectious complication rates were 4.0% (8/202) in group 1 and 1.3% (3/228) in group 2 (p=0.075). Urinary tract infection and acute prostatitis were more frequent in group 1 (3.5% vs. 0.4%, p=0.029). Infectious complication rates in ESBL negative patients were 3.4% (5/145) in group 1 and 1.3% (2/156) in group 2, whereas those in ESBL positive patients were 7.0% (4/57) in group 1 and 1.4% (1/72) in group 2.Conclusions: Increasing the dosage of amikacin for ciprofloxacin prophylaxis reduce infectious complications in patients with FQ-resistant rectal flora and to be more effective in ESBL positive patients with FQ-resistant rectal flora.

참고문헌 (28)

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Infectious Complications after Prostate Biopsy: A Prospective Multicenter Prostate Biopsy Study정홍, 권동득, 김광현, 김기호, 김영호, 김태형, 김태환, 김태효, 나용길, 민승기, 박성운, 박흥재, 배상락, 심봉석, 양승옥, 양승우, 유호송, 윤하나, 이길호, 이동현, 이상돈, 이서연, 이선주, 이승주, 임동훈, 장인호, 정승일, 정재민, 조용현, 조원열, 조원진, 최현섭, 하유신, 한준현, 한창희, 허정식, 황의창, 대한요로생식기감염학회대한요로생식기감염학회 · Urogenital Tract Infection2016 · 제11권 제1호경직장전립선 생검환자에서 감염 합병증정승일대한요로생식기감염학회 · Urogenital Tract Infection2013 · 제8권 제1호Changes of Antimicrobial Resistance Causing Infections Following Transrectal Prostate Biopsy: Analysis of 10-Year DataDa Eun Han, Du Geon Moon, Hong Seok Park, Jong Wook Kim, Mi Mi Oh, Sun Tae Ahn대한요로생식기감염학회 · Urogenital Tract Infection2021 · 제16권 제3호경직장초음파 유도하 전립선 생검 후 ciprofloxacin 내성균에 의한 세균혈증의 임상 특성권동득, 김진웅, 류수방, 박광성, 신보성, 정승일, 황의창대한요로생식기감염학회 · Urogenital Tract Infection2011 · 제6권 제1호경직장초음파하 전립선조직검사 후 발생한 발열을 동반한 요로감염의 위험인자김영주, 김현주, 허정식대한요로생식기감염학회 · Urogenital Tract Infection2012 · 제7권 제1호단일 술자에 의해 외래에서 시행된 경직장초음파하 전립선침생검 후 Betadine 거즈 압박이 입원을 요하는 합병증의 발생에 미치는 영향정홍, 김홍섭, 양상국대한요로생식기감염학회 · Urogenital Tract Infection2012 · 제7권 제1호

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