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MINERVA UROLOGICA E NEFROLOGICA
A Journal on Nephrology and Urology
Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 0,536
Minerva Urologica e Nefrologica 2006 March;58(1):73-80
Antibacterial prophylaxis in endourological procedures
Prezioso D. 1, Bartoletti R. 2, Damiano R. 3, Morgia G. 4
1 Dipartimento Scienze Ginecologiche ed Urologiche Università degli Studi Federico II, Napoli
2 Dipartimento di Urologia Università degli Studi di Firenze, Firenze
3 Dipartimento di Urologia Università Magna Grecia, Catanzaro
4 Dipartimento di Urologia Università degli Studi di Sassari, Sassari
Aim. Antibiotic prophylaxis for the prevention of postsurgical infections is a common practice in urologic surgery, as well as in endourologic procedures, both in at risk patients (local or systemic risk factors: age, immunological status, metabolic disorders, poor general conditions) or with a positive urine culture, but also in patients with urine previously sterile. As Gram-negative strains are the most common pathogens, it is reasonable to use a quinolone or a beta-lactam.
Methods. One-hundred and thirty-one patients (range 21-89 years) underwent transurethral cystoscopy (52 cases), vesical catheterism (44 cases), extracorporeal shockwave lithotripsy (17 cases) and transrectal prostatic biopsy (18 cases). An antimicrobial prophylaxis with ciprofloxacin 500 mg (22 patients, 16.8%), levofloxacin 500 mg (54 patients, 41.2%) and prulifloxacin 600 mg (55 patients, 42%) was administered.
Results. Globally, the incidence of urinary tract infections during 15 days after surgery was 8.4% (11 cases out of 131): ciprofloxacin 9.1%, levofloxacin 11.1% and prulifloxacin 5.5%, respectively. The patients compliance with the prophylactic treatment was good or excellent in 122 cases (93.1%) and poor in 9 cases (6.9%). No major differences between antibiotics used in prophylaxis were detected, keeping into account the limited size of the global population and subgroups defined by the endourological procedures.
Conclusion. Prulifoxacin, with a broad antimicrobial spectrum, favourable pharmacokinetic properties and easy to use, can be considered a valid and well tolerated therapeutic option for the antibacterial prophylaxis in endourological procedures, both in hospital and in outpatient setting.