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首页> 外文期刊>Sao Paulo Medical Journal >A randomized and prospective study on the value of antibiotic prophylaxis administration in transurethral resection of the prostate
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A randomized and prospective study on the value of antibiotic prophylaxis administration in transurethral resection of the prostate

机译：抗生素预防性应用在经尿道前列腺电切术中的价值的随机和前瞻性研究

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CONTEXT: Antibiotic prophylaxis in transurethral resection of the prostate is a regular practice in urology. However, its prophylactic effect can be questioned when the antiseptic surgical technique is used. Nonetheless, urine culture-oriented antibiotic therapy is the gold standard for avoiding improper medication usage and bacterial resistance. OBJECTIVE: To study the efficacy of antibiotic usage in patients with negative urine cultures, who were submitted to transurethral resection of the prostate. TYPE OF STUDY: Prospective open labeled study. SETTING: Tertiary care referral hospital PARTICIPANTS: 124 consecutive patients, who were randomly divided into two groups to receive antibiotic prophylaxis or not. MAIN MEASUREMENTS: Cultures from meatus, urine, irrigation and antiseptic fluid, and prostate tissue chips, were compared and analyzed for bacterial sensitivity to the antibiotic used, according to the surgeon's personal criteria. McLennan's test was used for statistical analysis. RESULTS: No statistically significant difference regarding clinical evolution was found between the groups that received or antibiotics or not. Statistical significance was found regarding the occurrence of positive urine cultures during the postoperative period for those not receiving antibiotics, but not in relation to fever, prostate chip culture or bacteremic episodes. Sixty-eight subjects (57.1%) presented positive prostatic tissue culture. There was no specific correlation between the recovered bacteria from the meatus, prostatic tissue chip and urine and the spectrum of the administered antibiotic. Six cases showed the same bacteria in the urine and prostatic tissue chip. Only fifteen cases (25%) in the antibiotic group showed the desired sensitivity directed to the collected bacteria. CONCLUSIONS: Antibiotic prophylaxis for patients whose urine is sterile is debatable in patients who are candidates for transurethral resection of the prostate. Most of the time, the antibiotic agent used is not specific for any of the bacteria recovered from the various sources analyzed.
机译：背景：经尿道前列腺电切术中的抗生素预防是泌尿科的常规做法。然而，当使用防腐外科技术时，其预防作用可能会受到质疑。尽管如此，以尿培养为导向的抗生素治疗是避免药物使用不当和细菌耐药性的金标准。目的：研究对经尿道前列腺电切术尿液培养阴性的患者使用抗生素的疗效。研究类型：前瞻性开放标记研究。单位：三级转诊医院参加者：124例连续的患者，随机分为两组接受或不接受抗生素预防。主要测量：根据外科医生的个人标准，比较并分析了来自鼻道，尿液，冲洗液和消毒液以及前列腺组织碎片的培养物，并分析了其对所用抗生素的细菌敏感性。麦克伦南的检验用于统计分析。结果：无论是否接受抗生素治疗的组之间，在临床进展方面均无统计学差异。对于未接受抗生素治疗的患者，其术后尿培养阳性的发生率具有统计学意义，但与发烧，前列腺芯片培养或细菌性发作无关。六十八名受试者（57.1％）表现出阳性的前列腺组织培养。从鼻道，前列腺组织芯片和尿液中回收的细菌与所用抗生素的光谱之间没有特定的相关性。六个病例在尿液和前列腺组织芯片中显示相同的细菌。抗生素组中只有十五例（25％）显示出针对所收集细菌的期望敏感性。结论：对于尿道无菌的患者，经尿道前列腺电切术的患者应采取抗生素预防措施。在大多数情况下，所使用的抗生素对从各种分析来源回收的任何细菌都不具有特异性。

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