經直腸前列腺切片術後併發症與預防性抗生素的使用
洪肇澤,林佳達,楊緒棣
台灣台北慈濟醫院泌尿部
Antimicrobial Prophylaxis and Febrile Complication of Transrectal Prostate Biopsy in Taipei Tzuchi Hospital and in Taiwan
Chao-Tse Hung, Chia-Da Lin, and Stephen Shei-Dei Yang
Department of urology, Taipei Tzu Chi General Hospital, Taiwan
Abstract
Background/Purpose: To analyze the antimicrobial prophylaxis (AMP) and febrile complications of transrectal prostate ultrasound-guided biopsy (TRUSPBX) in our hospital and review the current status in Taiwan.
Materials and methods: We retrospectively reviewed the patients who underwent TRUSPBX from January 2005 to December 2013 in our outpatient department. The patients were divided into two groups: group 1 contains those who took single dose 500 mg. levofloxacin pre-operatively, and group 2 consists those who received more than one dose of antibiotics regardless of medication category. We analyze the febrile outcome and related risks. We also reviewed some literatures who reported their outcome in other hospitals of Taiwan.
Results: Totally 737 patients were included for analysis (628 in Group 1, 109 in group 2). In group 1, 4 patient had fever (0.64%) after operation, while there was no patient experienced febrile complication in group 2 (p=0.9). There were no specific risks for febrile UTI of TRUSPBX in our hospital. The incidence of febrile complications with AMP of single dose levofloxacin is 0.64-1.99% in Taiwan. This regimen was effective and safe as AUA and EUA recommended. More than one dose of antibiotics before or after TRUSPBX is not necessary for patients with low risk of fever.
Conclusion: Single dose levofloxacin as AMP for TRUSPBX is safe and effective in Taiwan This regimen should be more widely use in all patients undergoing TRUSPBX with low risk of infection in Taiwan.