본문 바로가기
KERD
논문KCI 등재

전립선수술에 대한 예방적 항생제요법

Antimicrobial Prophylaxis for Prostatic Surgery

정승일
대한요로생식기감염학회|2014.04|Urogenital Tract Infection|제9권 제1호|pp. 14-20

2

조회

0

다운로드

2

인용

0

참고문헌

키워드

ProstateAntibiotic prophylaxisSurgical wound infectionsPostope-rative complications
주제분류비뇨기과학

초록

Antimicrobial prophylaxis is the periprocedural systemic administration of an antimicrobial agent intended to reduce the risk of postprocedural local and systemic infection. However, the use of antibiotics in urologic surgery has been controversial for decades. Significant progress in prostate surgery was made during the previous decade, however, controversy over antibiotic prophylaxis for prostatic surgery remains. In the context of surgical field classification, transurethral resection of the prostate and radical prostatectomy can be categorized according to a clean-contaminated operation. Therefore, in this regard, administration of prophylactic antibiotics is appropriate for prevention of postoperative infectious complications. Unfortunately, however, studies of the prophylactic effect of antimicrobial therapy with prostatic surgery have been limited. There is currently a lack of information on the risk factors for infectious complications associated with prostate surgery in Korea. In addition, the Korean National Health Insurance System recently recommended the use of current guidelines for surgical site infection focusing on gastrointestinal surgery, not urinary tract infection in patients undergoing prostate surgery without any Korean evidence. Because many urological procedures are associated with urine exposure and endourological procedures, these guidelines cannot be adapted to urologic prostatic surgery. In open or laparoscopic prostatic surgery (radical prostatectomy or prostatectomy), the urinary tract is opened during the procedure; thus, postoperative bacteriuria is probably the main source of postoperative infectious complications.

Abstract

Antimicrobial prophylaxis is the periprocedural systemic administration of an antimicrobial agent intended to reduce the risk of postprocedural local and systemic infection. However, the use of antibiotics in urologic surgery has been controversial for decades. Significant progress in prostate surgery was made during the previous decade, however, controversy over antibiotic prophylaxis for prostatic surgery remains. In the context of surgical field classification, transurethral resection of the prostate and radical prostatectomy can be categorized according to a clean-contaminated operation. Therefore, in this regard, administration of prophylactic antibiotics is appropriate for prevention of postoperative infectious complications. Unfortunately, however, studies of the prophylactic effect of antimicrobial therapy with prostatic surgery have been limited. There is currently a lack of information on the risk factors for infectious complications associated with prostate surgery in Korea. In addition, the Korean National Health Insurance System recently recommended the use of current guidelines for surgical site infection focusing on gastrointestinal surgery, not urinary tract infection in patients undergoing prostate surgery without any Korean evidence. Because many urological procedures are associated with urine exposure and endourological procedures, these guidelines cannot be adapted to urologic prostatic surgery. In open or laparoscopic prostatic surgery (radical prostatectomy or prostatectomy), the urinary tract is opened during the procedure; thus, postoperative bacteriuria is probably the main source of postoperative infectious complications.

참고문헌 (34)

  1. Grabe M, "Controversies in antibiotic prophylaxis in urology. Int J Antimicrob Agents", Int J Antimicrob Agents, 23(Suppl 1), pp.S17~S23 (2004)
  2. Bratzler DW, "Antimicrobial prophylaxis for surgery : an advisory statement from the National Surgical Infection Prevention Project", Am J Surg, 189, pp.395~404 (2005)
  3. Kirkland KB, "The impact of surgical-site infections in the 1990s : attributable mortality, excess length of hospitalization, and extra costs", Infect Control Hosp Epidemiol, 20, pp.725~730 (1999)
  4. "National Nosocomial Infections Surveillance (NNIS) report, data summary from October 1986-April 1996, issued May 1996. A report from the National Nosocomial Infections Surveillance (NNIS) System", Am J Infect Control, 24, pp.380~388 (1996)
  5. Kunin CM, "Nosocomial urinary tract infections and the indwelling catheter: what is new and what is true?", Chest, 120, pp.10~12 (2001)
  6. Grabe M, "Perioperative antibiotic prophylaxis in urology", Curr Opin Urol, 11, pp.81~85 (2001)
  7. Bratzler DW, "Use of antimicrobial prophylaxis for major surgery : baseline results from the National Surgical Infection Prevention Project", Arch Surg, 140, pp.174~182 (2005)
  8. Berry A, "Prophylactic antibiotic use in transurethral prostatic resection : a meta-analysis", J Urol, 167, pp.571~577 (2002)
  9. Qiang W, "Antibiotic prophylaxis for transurethral prostatic resection in men with preoperative urine containing less than 100, 000bacteria per ml : a systematic review", J Urol, 173, pp.1175~1181 (2005)
  10. Bratzler DW, "Antimicrobial prophylaxis for surgery : an advisory statement from the National Surgical Infection Prevention Project", Clin Infect Dis, 38, pp.1706~1715 (2004)
  11. "Antimicrobial prophylaxis for surgery", Treat Guidel Med Lett, 2, pp.27~32 (2004)
  12. Mangram AJ, "Guideline for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee", Infect Control Hosp Epidemiol, 20, pp.250~278 (1999)
  13. Page CP, "Antimicrobial prophylaxis for surgical wounds. Guidelines for clinical care", Arch Surg, 128, pp.79~88 (1993)
  14. "Antimicrobial prophylaxis in surgery", Med Lett Drugs Ther, 43, pp.92~97 (2001)
  15. Burke JF, "The effective period of preventive antibiotic action in experimental incisions and dermal lesions", Surgery, 50, pp.161~168 (1961)
  16. Classen DC, "The timing of prophylactic administration of antibiotics and the risk of surgical-wound infection", N Engl J Med, 326, pp.281~286 (1992)
  17. Bates T, "Timing of prophylactic antibiotics in abdominal surgery:trial of a pre-operative versus an intra-operative first dose", Br J Surg, 76, pp.52~56 (1989)
  18. Sabbagh R, "A prospective randomized trial of 1-day versus 3-day antibiotic prophylaxis for transrectal ultrasound guided prostate biopsy", Can J Urol, 11, pp.2216~2219 (2004)
  19. Bergamini TM, "The importance of tissue antibiotic activity in the prevention of operative wound infection", J Antimicrob Chemother, 23, pp.301~313 (1989)
  20. Grabe M, "Guidelines on urological infections", Eur Assoc Urology, pp.76~90 (2013)
  21. Wolf JS Jr, "Best practice policy statement on urologic surgery antimicrobial prophylaxis", J Urol, 179, pp.1379~1390 (2008)
  22. Matsumoto T, "Japanese guidelines for prevention of perioperative infections in urological field", Int J Urol, 14, pp.890~909 (2007)
  23. Kahlmeter G, "Prevalence and antimicrobial susceptibility of pathogens in uncomplicated cystitis in Europe. The ECO.SENS study", Int J Antimicrob Agents, 22(Suppl 2), pp.49~52 (2003)
  24. Lee SJ, "Current status of antimicrobial resistance among bacterial pathogens causing urinary tract infection in Korea", Korean J Urogenit Tract Infect Inflamm, 4, pp.37~46 (2009)
  25. 유광호, "최근 요로감염증의 주요 원인균과 항생제 감수성에 관한 고찰", Investigative and Clinical Urology, 48(6), pp.638~645 (2007), 대한비뇨기과학회
  26. Çek M, "Antibiotic prophylaxis in urology departments, 2005-2010", Eur Urol, 63, pp.386~394 (2013)
  27. Naber KG, "EAU guidelines for the management of urinary and male genital tract infections", Eur Urol, 40, pp.576~588 (2001)
  28. Grabe M, "Preoperative assessment of the patient and risk factors for infectious complications and tentative classification of surgical field contamination of urological procedures", World J Urol, 30, pp.39~50 (2012)
  29. Childs SJ, "Appropriate surgical prophylaxis in transurethral genitourinary surgery and potential reduction in nosocomial infections", Urology, 27, pp.415~420 (1986)
  30. Bootsma AM, "Antibiotic prophylaxis in urologic procedures : a systematic review", Eur Urol, 54, pp.1270~1286 (2008)
  31. Terai A, "Antibiotic prophylaxis in radical prostatectomy : 1-day versus 4-day treatments", Int J Urol, 13, pp.1488~1493 (2006)
  32. Takeyama K, "Comparison of 1-day, 2-day, and 3-day administration of antimicrobial prophylaxis in radical prostatectomy", J Infect Chemother, 13, pp.320~323 (2007)
  33. Sakura M, "Prospective comparative study of single dose versus 3-day administration of antimicrobial prophylaxis in minimum incision endoscopic radical prostatectomy", Int J Urol, 15, pp.328~331 (2008)
  34. Taoka R, "Antimicrobial prophylaxis in radical prostatectomy : single dose versus 1-day treatment", Hinyokika Kiyo, 56, pp.559~563 (2010)

이 간행물의 다른 논문 (10건)

재발성 요로감염에 대한 예방적 항생제 요법박민구, 조대연pp. 1-8재발성 요로감염에 대한 비항생제 예방요법김기호pp. 9-13만성 세균성 전립선염박흥재pp. 21-26Modulation of Antimicrobial Peptide Human β-defensin-3 by Toll-like Receptor Ligands in Vaginal Epithelial Cells명순철, 김해종, 문영태, 장인호, 김경도, 한준현, 이소연pp. 27-33방광요관역류 소아에서 내시경 수술 후 요로감염의 빈도 및 위험인자구자윤, 박부경, 이상돈pp. 34-38
원문 보기