Efficacy of two-time prophylactic intravenous administration of tazobactam/piperacillin for transrectal ultrasound-guided needle biopsy of the prostate
Background: Prevalence of fluoroquinolone (FQ)-resistant Escherichia coli has been recently increasing worldwide. We analyzed the incidence and characteristics of acute bacterial prostatitis after transrectal ultrasound-guided needle prostate biopsy (TRUSP-Bx) with prophylactic tazobactam/piperacill...
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| Format: | Article |
| Language: | English |
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Elsevier
2015-09-01
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| Series: | Prostate International |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2287888215000434 |
| _version_ | 1797706788434345984 |
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| author | Hiroaki Iwamoto Kazuyoshi Shigehara Tohru Miyagi Takao Nakashima Masayoshi Shimamura Mikio Namiki |
| author_facet | Hiroaki Iwamoto Kazuyoshi Shigehara Tohru Miyagi Takao Nakashima Masayoshi Shimamura Mikio Namiki |
| author_sort | Hiroaki Iwamoto |
| collection | DOAJ |
| description | Background: Prevalence of fluoroquinolone (FQ)-resistant Escherichia coli has been recently increasing worldwide. We analyzed the incidence and characteristics of acute bacterial prostatitis after transrectal ultrasound-guided needle prostate biopsy (TRUSP-Bx) with prophylactic tazobactam/piperacillin (TAZ/PIPC) treatment as an alternative regimen.
Methods: A total of 391 patients who underwent TRUSP-Bx were included in the study. All patients received intravenous TAZ/PIPC (4.5 g) 30 minutes before and 6 hours after TRUSP-Bx.
Results: Acute bacterial prostatitis developed in six patients (1.5%); the frequency of its occurrence was significantly higher in patients in whom rectal disinfection was not performed (P<0.05). These six patients developed clinical symptoms of acute bacterial prostatitis a median of 24 hours after the biopsy. Escherichia coli was isolated in urine or blood bacterial cultures in four cases, and Klebsiella pneumoniae in two cases. All of the isolated organisms showed excellent sensitivity to TAZ/PIPC.
Conclusions: The incidence rate of acute prostatitis with prophylactic TAZ/PIPC was consistent with those reported previously with FQ-based regimens, despite the favorable sensitivity of isolated organisms. Two-time regimen of TAZ/PIPC may not always prevent the post-TRUSP-Bx infection, possibly due to the pharmacokinetic characteristics of TAZ/PIPC. However, if each case was considered individually to select the best setting and frequency of dosage of TAZ/PIPC, this can be an optimal prophylaxis in the era of widespread FQ-resistant microorganisms. |
| first_indexed | 2024-03-12T05:56:30Z |
| format | Article |
| id | doaj.art-6784951e5c574a54b862fbdc3dd0e56e |
| institution | Directory Open Access Journal |
| issn | 2287-8882 |
| language | English |
| last_indexed | 2024-03-12T05:56:30Z |
| publishDate | 2015-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Prostate International |
| spelling | doaj.art-6784951e5c574a54b862fbdc3dd0e56e2023-09-03T04:30:22ZengElsevierProstate International2287-88822015-09-013310310610.1016/j.prnil.2015.06.001Efficacy of two-time prophylactic intravenous administration of tazobactam/piperacillin for transrectal ultrasound-guided needle biopsy of the prostateHiroaki Iwamoto0Kazuyoshi Shigehara1Tohru Miyagi2Takao Nakashima3Masayoshi Shimamura4Mikio Namiki5Department of Urology, Ishikawa Prefectural Central Hospital, Kanazawa, JapanDepartment of Urology, Ishikawa Prefectural Central Hospital, Kanazawa, JapanDepartment of Urology, Ishikawa Prefectural Central Hospital, Kanazawa, JapanDepartment of Urology, Ishikawa Prefectural Central Hospital, Kanazawa, JapanDepartment of Urology, Nomi City Hospital, Nomi, JapanDepartment of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, JapanBackground: Prevalence of fluoroquinolone (FQ)-resistant Escherichia coli has been recently increasing worldwide. We analyzed the incidence and characteristics of acute bacterial prostatitis after transrectal ultrasound-guided needle prostate biopsy (TRUSP-Bx) with prophylactic tazobactam/piperacillin (TAZ/PIPC) treatment as an alternative regimen. Methods: A total of 391 patients who underwent TRUSP-Bx were included in the study. All patients received intravenous TAZ/PIPC (4.5 g) 30 minutes before and 6 hours after TRUSP-Bx. Results: Acute bacterial prostatitis developed in six patients (1.5%); the frequency of its occurrence was significantly higher in patients in whom rectal disinfection was not performed (P<0.05). These six patients developed clinical symptoms of acute bacterial prostatitis a median of 24 hours after the biopsy. Escherichia coli was isolated in urine or blood bacterial cultures in four cases, and Klebsiella pneumoniae in two cases. All of the isolated organisms showed excellent sensitivity to TAZ/PIPC. Conclusions: The incidence rate of acute prostatitis with prophylactic TAZ/PIPC was consistent with those reported previously with FQ-based regimens, despite the favorable sensitivity of isolated organisms. Two-time regimen of TAZ/PIPC may not always prevent the post-TRUSP-Bx infection, possibly due to the pharmacokinetic characteristics of TAZ/PIPC. However, if each case was considered individually to select the best setting and frequency of dosage of TAZ/PIPC, this can be an optimal prophylaxis in the era of widespread FQ-resistant microorganisms.http://www.sciencedirect.com/science/article/pii/S2287888215000434Acute bacterial prostatitisPiperacillin/tazobactamProstate biopsyRectal disinfection |
| spellingShingle | Hiroaki Iwamoto Kazuyoshi Shigehara Tohru Miyagi Takao Nakashima Masayoshi Shimamura Mikio Namiki Efficacy of two-time prophylactic intravenous administration of tazobactam/piperacillin for transrectal ultrasound-guided needle biopsy of the prostate Prostate International Acute bacterial prostatitis Piperacillin/tazobactam Prostate biopsy Rectal disinfection |
| title | Efficacy of two-time prophylactic intravenous administration of tazobactam/piperacillin for transrectal ultrasound-guided needle biopsy of the prostate |
| title_full | Efficacy of two-time prophylactic intravenous administration of tazobactam/piperacillin for transrectal ultrasound-guided needle biopsy of the prostate |
| title_fullStr | Efficacy of two-time prophylactic intravenous administration of tazobactam/piperacillin for transrectal ultrasound-guided needle biopsy of the prostate |
| title_full_unstemmed | Efficacy of two-time prophylactic intravenous administration of tazobactam/piperacillin for transrectal ultrasound-guided needle biopsy of the prostate |
| title_short | Efficacy of two-time prophylactic intravenous administration of tazobactam/piperacillin for transrectal ultrasound-guided needle biopsy of the prostate |
| title_sort | efficacy of two time prophylactic intravenous administration of tazobactam piperacillin for transrectal ultrasound guided needle biopsy of the prostate |
| topic | Acute bacterial prostatitis Piperacillin/tazobactam Prostate biopsy Rectal disinfection |
| url | http://www.sciencedirect.com/science/article/pii/S2287888215000434 |
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