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809 CAN PENICILLIN INCLUDING BETA-LACTAMASE INHIBITOR OVERCOME FEBRILE COMPLICATIONS AFTER TRANSRECTAL PROSTATE BIOPSY?

2010; Lippincott Williams & Wilkins; Volume: 183; Issue: 4S Linguagem: Inglês

10.1016/j.juro.2010.02.1485

1527-3792

Katsumi Shigemura, Tomihiko Yasufuku, Minoru Matsumoto, Yoshihisa Kinoshita, Kunito Yamanaka, Masuo Yamashita, Yuzo Nakano, Kazushi Tanaka, Sochi Arakawa, Masato Fujisawa,

Genital Health and Disease

You have accessJournal of UrologyInfections/Inflammation of the Genitourinary Tract: Prostate & Genitalia1 Apr 2010809 CAN PENICILLIN INCLUDING BETA-LACTAMASE INHIBITOR OVERCOME FEBRILE COMPLICATIONS AFTER TRANSRECTAL PROSTATE BIOPSY? Katsumi Shigemura, Tomihiko Yasufuku, Minoru Matsumoto, Yoshihisa Kinoshita, Kunito Yamanaka, Masuo Yamashita, Yuzo Nakano, Kazushi Tanaka, Sochi Arakawa, and Masato Fujisawa Katsumi ShigemuraKatsumi Shigemura Akashi, Japan , Tomihiko YasufukuTomihiko Yasufuku Kobe, Japan , Minoru MatsumotoMinoru Matsumoto Kobe, Japan , Yoshihisa KinoshitaYoshihisa Kinoshita Akashi, Japan , Kunito YamanakaKunito Yamanaka Akashi, Japan , Masuo YamashitaMasuo Yamashita Akashi, Japan , Yuzo NakanoYuzo Nakano Kobe, Japan , Kazushi TanakaKazushi Tanaka Kobe, Japan , Sochi ArakawaSochi Arakawa Kobe, Japan , and Masato FujisawaMasato Fujisawa Kobe, Japan View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1485AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Prostate biopsy (PBx) is a routine procedure for the detection of prostate cancer (PC); however, it may happen a problem of febrile complications after PBx especially in transrectal approach. This is partly because of emergence and spread of fluoroquinolones (FQs)-resistant Eschelichia coli in recent years in spite that FQs have been often used for this prophylactic purpose for PBx and has a good concentration in prostrate after dosing. Importantly, extended-spectrum β-lactamase (ESBL) - producing E.coli was also emerged and spread and is known to resistant to most kinds of antibiotics. This is the comparison study regarding prophylactic medication of PBx with three categories: 1) penicillin including beta-lactamase inhibitor alone; 2) penicillin including beta-lactamase inhibitor + levofloxacin (LVFX); and 3) aminoglycosides + LVFX in order to investigate the efficacy of penicillin including beta-lactamase inhibitor. METHODS We conducted PBx in two institutions. Group 1) was performed in Kobe University Hospital and 2) and 3) were in Akashi Municipal Hospital from July 2008 to November 2009. In detail, Group 1 was tazobactam/piperacillin (TAZ/PIPC) 13.5 g i.v. per day (just before, 4 hrs and 12 hrs later of PBx) (n=187); Group 2 was TAZ/PIPC 9 g i.v. per day (just before and 3 hrs later of PBx) and oral LVFX 300 mg or 500 mg per day for 3 days (n=100); Group 3 was isepamicin 100 mg i.v. per day (just beofre PBx) and oral LVFX 300 mg for 3 days (n=100). We recorded the febrile cases after PBx such as acute bacterial prostatitis and treated those cases with 3rd and 4th cephalosporines or carbapenems. The comparison study was conducted with statistical analyses. As a rule, sextant + TZ ± far lateral transrectal PBx was performed. RESULTS The ratios of the febrile complication occurrence was 7/187 (3.74 %) in Group 1, 0/100 (0%) in Group 2, and 5/100 (5.0 %) in Group 3, respectively. Group 2 showed significantly lower rate than other groups (p<0.05). Our positive urine culture (5 cases) tests in febrile cases showed E.coli occupied 4/5(33.3 %) and no ESBL-producing E.coli cases, and LVFX-resistant E.coli was 3/4(75%) cases, and there were 2 gentamicin-resistant and 1 amikacin-resistant E.coli. No drug induced side effects were observed in all cases and all febrile cases were cured by appropriate antibiotics therapies. CONCLUSIONS TAZ/PIPC 9 g i.v. per day (just before and 3 hrs later of PBx) and oral LVFX for 3 days could be a recommended method with low febrile complication for prophylactic medication for prostate biopsy. © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byPearle M (2011) Should We Change Our Prophylactic Antimicrobial Regimen for Prostate Biopsy?Journal of Urology, VOL. 185, NO. 4, (1181-1183), Online publication date: 1-Apr-2011. Volume 183Issue 4SApril 2010Page: e316 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.Metrics Author Information Katsumi Shigemura Akashi, Japan More articles by this author Tomihiko Yasufuku Kobe, Japan More articles by this author Minoru Matsumoto Kobe, Japan More articles by this author Yoshihisa Kinoshita Akashi, Japan More articles by this author Kunito Yamanaka Akashi, Japan More articles by this author Masuo Yamashita Akashi, Japan More articles by this author Yuzo Nakano Kobe, Japan More articles by this author Kazushi Tanaka Kobe, Japan More articles by this author Sochi Arakawa Kobe, Japan More articles by this author Masato Fujisawa Kobe, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...