gms | German Medical Science

44. Gemeinsame Tagung der Bayerischen Urologenvereinigung und der Österreichischen Gesellschaft für Urologie und Andrologie

14. - 16.06.2018, Rosenheim

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Efficacy and safety of different dosages of fosfomycin as antimicrobial prophylaxis in transrectal biopsy of the prostate

Meeting Abstract

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  • Carolina D'Elia - Zentralkrankenhaus Bozen
  • Emauela Trenti - Zentralkrankenhaus Bozen
  • Christian Ladurner - Zentralkrankenhaus Bozen
  • Salvatore Palermo - Zentralkrankenhaus Bozen
  • Evi Comploj - Zentralkrankenhaus Bozen; Department of Research, College of Health Care Professions, Claudiana
  • Omar Saleh - Careggi University, Urology Dpt, Florenz
  • Greta Spoladore - Krankenhaus Bozen, Urologie, Bozen, Italien
  • Tommaso Cai - Santa Chiara Hospital, Trento
  • Peter Mian - Krankenhaus Bozen, Urologie, Bozen, Italien
  • Armin Pycha - Zentralkrankenhaus Bozen; Sigmund Freud Private University, Medical School, Wien Österreich

Bayerische Urologenvereinigung. Österreichische Gesellschaft für Urologie und Andrologie. 44. gemeinsamen Tagung der Bayerischen Urologenvereinigung und der Österreichischen Gesellschaft für Urologie und Andrologie. Rosenheim, 14.-16.06.2018. Düsseldorf: German Medical Science GMS Publishing House; 2018. Doc18urobay064

doi: 10.3205/18urobay064, urn:nbn:de:0183-18urobay0645

Veröffentlicht: 17. Mai 2018

© 2018 D'Elia et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Introduction: Fosfomycin shows a good activity against gram positive and gram negative bacteria and a good oral bioavailability. The aim of our randomized study was to evaluate efficacy and safety of a prostate biopsy phrophylaxis protocol using 2 VS 3 fosfomycin dosis.

Materials and methods: 297 patients undergoing transrectal US guided (n:277) or fusion prostate biopsy (n:20) were prospectively evaluated in a single Italian center. The patients were randomized to 2 groups; - A: fosfomycin 3 gr within 4 hours from the procedure and after 24 hours; - B: fosfomycin 3 gr about 12 hours before the procedure, within 4 hours from the procedure and after 24 hours. Randomization was carried out by date of birth.

Results: 297 patients were randomized to group A (n:162) or group B (n:135). The groups were comparable with respect to age, comorbidity, PSA, prostate volume, operative time and urine culture. 9 patients developed fever <38° after the procedure and were treated empirically with quinolones; none of the urinculture (n 4) showed strains resistant to fosfomycin. 2.7% (8/297) developed fever >38° (after mean 2.7 days) requiring a readmission, 6 (3.7%) in group A and 2 (1.5%) in group B, p 0.29). 3 pts presented respectively positive urineculture (1 positive for Enterobacter resistant to fosfomycin) and 2 presented a positive hemoculture (only 1a Klebsiella pneumoniae resistant to fosfomycin). The patients who were readmitted differ from the other patiens only with regard to the type of prostate biopsy; patients who underwent fusion biopsy were more frequently readmitted (p 0.000).

Conclusions: The low fever and prostatitis rate shows that fosfomycin prophylaxis is safe and efficacy; moreover, the two dosage seem to be overlapping in term of post-operative outcomes.