單獨使用levofloxacin與levofloxacin加上gentamicin在經直腸攝護腺切片之預防性抗生素之比較
朱懿柏1、葉志胤1、吳子翔1 、何肇晏1、林宜佳1,2、蔡德甫1,2、陳宏恩1、
仇光宇1,2、鄭以弘1、葉忠信1,2、莊光達1,2、黃一勝1,2
1財團法人新光吳火獅紀念醫院外科部泌尿外科
2天主教輔仁大學醫學院泌尿外科
Comparison of levofloxacin and levofloxacin plus gentamicin for prophylaxis of transrectal prostate biopsy
Yi-Bo Chu1、Chih-Yin Yeh1、Tzu-Hsiang Wu1、Chao-YenHo1、Yi-Chia Lin1,2、Te-Fu Tsai1,2、
Hung-En Chen1、Kung-Yu Chou1,2、Yi-Hung Cheng1、Chung-Hsin Yeh1,2、
Guang-Dar Juang1,2、Thomas I.S. Hwang1,2
1 Division of Urology, Department of Surgery, Shin-Kong WHS Memorial Hospital, Taipei, Taiwan
2Department of Urology, Fu Jen Catholic University School of Medicine, Taipei, Taiwan
Purpose: Transrectal prostate biopsy (TRPB) is well recommended procedure used to be obtain tissue for diagnosis of carcinoma of prostate. Even though TRPB is considered as a safe procedure, it still has the risk of infective complication. Currently, prophylatic antibiotic is usually initiated before the procedure but there is no consensus of type of antibiotic and the duration of the antibiotic. Here, we compared levofloxacin and levofloaxin plus gentamicin retrospectively.
Materials and Methods: From 2017 January to 2018 December, 319 patients were enrolled in this study retrospectively. Among those patients, 131 patients received levofloxacin alone and 188 patients received levofloxacin plus gentamicin for prophylaxis of TRPB. Demographics, PSA, prostate volume, and infection rate were analyzed.
Results: Among them, there was no difference in mean age between two groups (levofloxacin: 66.08 years old, levofloxacin plus gentamicin: 66.17 years old, p= 0.46). Prostatic volume was similar between two groups (levofloxacin: 44.19ml, levofloxacin plus gentamicin: 42.94ml, p= 0.21). The PSA level is higher in combination group without statistically significance (levofloxacin: 26.72ng/ml, levofloxacin plus gentamicin: 49.30ng/ml, p= 0.08. Therefore, combination group has significant lower infection rate than levoflaxacin along group (levofloxacin: 15%, levofloxacin plus gentamicin: 5%, p= 0.003).
Conclusion: The result showed that levofloxacin plus gentamicin has better post-TRPB infection rate than levofloxacin alone. According to the result and the spectrum with drug-resistance, we thought combination antibiotic or other alternative antibiotic may be more effective than levofloxacin alone for prophylaxis of TRPB.