Clinical effectiveness and safety of tazobactam/piperacillin 4.5 g for the prevention of febrile infectious complication after prostate biopsy

Yasuda, Mitsuru; Nakane, Keita; Yamada, Yoshiteru; Matsumoto, Masahiro; Sho, Takehiko; Matsumoto, Minori; Kobayashi, Kanao; Shigemura, Katsumi; Nakano, Yuzo; Tanaka, Kazushi; Hamasuna, Ryoichi; Ishihara, Satoshi; Arakawa, Soichi; Yamamoto, Shingo; Matsubara, Akio; Fujisawa, Masato; Deguchi, Takashi; Matsumoto, Tetsuro

doi:10.1016/j.jiac.2014.06.011

Cited by 14 publications

(18 citation statements)

References 15 publications

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“…These findings confirmed the recommendations in the 2015 Japanese guidelines for administration twice a day for 4.5 days in high‐risk patients (Fig. ) . However, PIPC/TAZ, a broad‐spectrum intravenous antibiotic treatment, should only be used for patients with high risk.…”

Section: Transrectal Approachsupporting

confidence: 84%

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Prevention of infectious complications after prostate biopsy procedure

Togo

Yamamoto

2017

Int J of Urology

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Although febrile complications are rarely encountered after a prostate biopsy procedure, in recent years the number of cases of fatal infection after that have increased along with increases in resistant bacteria. The available biopsy approaches are transrectal and transperineal, with the transrectal approach primarily used. As the invasion path of the puncture needle differs between these approaches, pretreatment and the method of administration of preventive antimicrobial drugs should be separately considered for infection prevention. Recently, the Japanese guidelines for perioperative infection prevention in the field of urology were revised after receiving approval from the Japanese Urological Association. With use of the transrectal approach, attempts have been made to selectively administer prophylactic antibiotics by confirming the presence or absence of resistant bacteria in rectal swab culture results before carrying out a prostate biopsy procedure because of potential problems associated with resistant bacteria in rectal flora. For preventive antibiotics, a single dose of oral quinolone is recommended for patients with low risk, whereas daily administrations of piperacillin/ tazobactam are recommended for those considered to be high risk. In contrast, for the transperineal procedure, a single dose of oral quinolone is recommended as a preventive antibiotic. With both approaches, it is important to empirically administer broad-spectrum antimicrobials when occurrence of a febrile infection after a prostate biopsy procedure is confirmed.

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Section: Transrectal Approachsupporting

confidence: 84%

“…1). 31 However, PIPC/TAZ, a broad-spectrum intravenous antibiotic treatment, should only be used for patients with high risk.…”

Section: Antibiotics For Preventionmentioning

confidence: 99%

Prevention of infectious complications after prostate biopsy procedure

Togo

Yamamoto

2017

Int J of Urology

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“…Like FQs, TAZ/PIPC has a wide spectrum of action against common urinary and colorectal flora, and some reports have demonstrated the prophylactic efficacy of TAZ/PIPC for bacterial infections after TRUSP-Bx [22–24] . TAZ/PIPC is a time-dependent antibiotic agent which differs from FQs in that it has a concentration-dependent antibiotic action.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of two-time prophylactic intravenous administration of tazobactam/piperacillin for transrectal ultrasound-guided needle biopsy of the prostate

Iwamoto

Shigehara

Miyagi

et al. 2015

Prostate International

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BackgroundPrevalence 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.MethodsA 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.ResultsAcute 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.ConclusionsThe 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.

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“…Additionally, a combination of aminoglycosides with quinolones or tazobactam/piperacillin can reduce the rate of infection, and is considered to be an optional selection (EL, IVa; RG, C1). As for AMP for high‐risk patients who have a large prostate volume of 75 mL or more, diabetes, steroid dosing, voiding dysfunction (IPSS ≥20, maximum urinary flow rate ≤12 mL/s, residual volume ≥100 mL) or immune‐suppression status, tazobactam/piperacillin at 4.5 g, twice for a single day is recommended (EL, III; RG, B) …”

Section: Detailed Exposition 8: Prostate Biopsymentioning

confidence: 99%

“…As for AMP for high-risk patients who have a large prostate volume of 75 mL or more, diabetes, steroid dosing, voiding dysfunction (IPSS ≥20, maximum urinary flow rate ≤12 mL/ s, residual volume ≥100 mL) or immune-suppression status, tazobactam/piperacillin at 4.5 g, twice for a single day is recommended (EL, III; RG, B). 81 Intrarectal disinfection using povidone iodine is recommended before a biopsy procedure, as a retrospective study carried out in Japan showed that non-performance of intrarectal disinfection was a significant risk factor for post-transrectal prostate biopsy infection (univariate analysis, P = 0.0001; EL, II; RG, B). 73 In addition, several studies have reported that targeted AMP is effective for reducing the rate of postprostate biopsy infection, thus a rectal swab culture in advance of a transrectal prostate biopsy is recommended, especially in cases with high risk, such as those with a history of previous treatment by antimicrobials.…”

Section: Amp For Transrectal Prostate Biopsy (Table 6)mentioning

confidence: 99%

Essential Japanese guidelines for the prevention of perioperative infections in the urological field: 2015 edition

Yamamoto

Shigemura

Kiyota³

et al. 2016

Int J of Urology

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After publication of the initial version of the Japanese guidelines for urological surgery in 2007, new surgical techniques have been introduced. Furthermore, several important issues, such as criteria for use of single-dose antimicrobial prophylaxis and control of hospitalized infection, were also established, which led to alterations of the methods used for antimicrobial prophylaxis as well as perioperative management. The purpose of antimicrobial prophylaxis is to protect the surgical wound from contamination by normal bacterial flora. Antimicrobial prophylaxis should be based on penicillins with beta-lactamase inhibitors, or first-or second-generation cephalosporins, though penicillins without beta-lactamase inhibitors should not be prescribed because of the high prevalence of antimicrobial resistance. As an adequate intratissue concentration of the antimicrobial at the surgical site should be accomplished by the time of initiation of surgery, antimicrobial prophylaxis should be started up to 30 min before beginning the operation. Antimicrobial prophylaxis should be terminated within 24 h in clean and clean-contaminated surgery, and within 2 days of surgery using the bowels, because a longer duration is a risk factor for surgical site infection development. Importantly, possible risk factors for surgical site infections include the antimicrobial prophylaxis methodology used as well as others, such as duration of preoperative hospitalization, hand washing, the American Society of Anesthesiologists score, diabetes and smoking history. These guidelines are to be applied only for preoperatively non-infected low-risk patients. In cases with preoperative infection or bacteriuria that can cause a surgical site infection or urinary tract infection after surgery, patients must receive adequate preoperative treatment based on the individual situation.

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Clinical effectiveness and safety of tazobactam/piperacillin 4.5 g for the prevention of febrile infectious complication after prostate biopsy

Cited by 14 publications

References 15 publications

Prevention of infectious complications after prostate biopsy procedure

Prevention of infectious complications after prostate biopsy procedure

Efficacy of two-time prophylactic intravenous administration of tazobactam/piperacillin for transrectal ultrasound-guided needle biopsy of the prostate

Essential Japanese guidelines for the prevention of perioperative infections in the urological field: 2015 edition

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