Prophylactic chemotherapy with fosfomycin trometamol during transurethral surgery and urological manœuvres. Results of a multicentre study

Silverio, F. Di; Ferrone, Giuliano; Carati, L.

doi:10.1007/bf01643436

Cited by 16 publications

(16 citation statements)

References 8 publications

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“…In a report, 23 bacterial adhesion to the bladder tumor caused postoperative UTIs, even if the preoperative urine was sterile, and the incidence of UTIs after TUR‐Bt was higher than that after TUR‐P. Therefore, AMP is recommended to prevent UTIs after TUR‐Bt 19,20,24–28 . Most strains isolated from UTIs after TUR‐Bt were Gram negatives 22,25,27 .…”

Section: Detailed Expositionmentioning

confidence: 99%

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Japanese guidelines for prevention of perioperative infections in urological field

et al. 2007

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For urologists, it is very important to master surgical indications and surgical techniques. On the other hand , the knowledge of the prevention of perioperative infections and the improvement of surgical techniques should always be considered. Although the prevention of perioperative infections in each surgical field is a very important issue, the evidence and the number of guidelines are limited. Among them, the preparation of guidelines has progressed , especially in gastrointestinal surgery. The Center for Disease Control and Prevention (CDC) proposed guidelines for the prevention of surgical site infections, which have been used worldwide. In urology, the original guidelines were different from those of general surgery, due to many endourological procedures and urine exposure in the surgical field. The Japanese Society of UTI Cooperative Study Group has thus framed these guidelines supported by The Japanese Urological Association. The guidelines consist of the following nine techniques: open surgeries, laparoscopic surgeries, transurethral resection of bladder tumor, ureterorenoscope and transurethral lithotripsy, transurethral resection of the prostate, prostate biopsy, cystourethroscope, pediatric surgeries in the urological field , and extracorporeal shock wave lithotripsy and febrile neutropenia. These are the first guidelines for the prevention of perioperative infections in the urological field in Japan. Although most of these guidelines were made using reliable evidence, there are parts without enough evidence. Therefore, if new reliable data is reported , it will be necessary for these guidelines to be revised in the future. Key words:Open surgery, Laparoscopic surgery, TUR, Prostate biopsy, Cystourethroscope, ESWL. I. General remarksUrological practice mainly consists of surgical procedures, since the field of urology is a division of surgery. Therefore, it is very important to master surgical indications and surgical techniques. On the other hand , the knowledge of the prevention of perioperative infections and the improvement of surgical techniques should always be considered. Although the prevention of perioperative infections in each surgical field is a very important issue, these evidences are limited and the number of guidelines is limited. Among them, the preparation of guidelines has progressed , especially in gastrointestinal surgery. The Center for Disease Control and Prevention (CDC) proposed guidelines for the prevention of surgical site infections), 1 which have been used worldwide. In urology, the original guidelines were different from those of general surgery, due to many endourological procedures and urine exposure in the surgical field. We have thus framed these guidelines supported by The Japanese Urological Association. I-I Definition and classification of perioperative infectionsA perioperative infection is defined as an infection that occurs within one month after an operation. These infections are divided into two groups: surgical site infections (SSIs) and remote i...

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Section: Detailed Expositionmentioning

confidence: 99%

“…Therefore, AMP is recommended to prevent UTIs after TUR‐Bt 19,20,24–28 . Most strains isolated from UTIs after TUR‐Bt were Gram negatives 22,25,27 . However, the distribution of streptococci from postoperative UTIs in female patients was reported to be high 29 .…”

Section: Detailed Expositionmentioning

confidence: 99%

Japanese guidelines for prevention of perioperative infections in urological field

et al. 2007

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“…The largest trial [14] was conducted as an open study in 72 urological surgical centers in Italy on 712 (mainly male) patients undergoing different transurethral interventions, i.e. surgical procedures, such as TURP (31.2%) and TURB (19.5%), in 53.5% of the patients and other endoscopic (mainly diagnostic) procedures in 46.5% of the patients, such as cystoscopy (38.9%), urodynamic studies (5.5%), lithotripsy (2.1%) and urethrotomy (2.8%).…”

Section: Ft For Pap In Endourological Interventions and Surgical Procmentioning

confidence: 99%

Fosfomycin Trometamol (3,000 mg) in Perioperative Antibiotic Prophylaxis of Healthcare-Associated Infections after Endourological Interventions: A Narrative Review

2013

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Introduction: Increasing antibiotic resistance also has an impact on perioperative antibiotic prophylaxis (PAP). This narrative review evaluates fosfomycin trometamol (FT) as PAP in endourological interventions. Materials and Methods: Nine clinical studies including 4 randomized comparative studies were analyzed. A total of 1,614 patients received FT as PAP for different endourological procedures and extracorporeal shock wave lithotripsy [ESWL; i.e. cystoscopy (n = 498), urodynamic studies (n = 39), ureteropyeloscopy (n = 10), urethrotomy (n = 20), lithotripsy (n = 15), transurethral resection of bladder tumors (n = 139), transurethral resection of the prostate (n = 843), ESWL (n = 20), ureterorenoendoscopic lithotripsy (n = 18), percutaneous nephrostomic lithotripsy (n = 12)]. Results: In 8 clinical studies, FT was shown to be effective in preventing healthcare-associated urinary tract infections (HAUTIs). One study showed no benefit. The usual dosage regimen was oral administration of 3 g of FT 3 h before and 24 h after the procedure. In 1 randomized comparative study investigating HAUTIs after diagnostic cystoscopy, it could also be shown that a single oral dose of 3 g of FT 3 h before cystoscopy was as effective as a double dose. Conclusion: According to the published results, for traumatic endourological interventions and surgical procedures, an oral dosage of 3 g of FT 3 h before and 24 h after the procedure and only 1 (prior) oral dosage for diagnostic procedures might be an alternative if PAP is indicated. Limitations of the studies are the low numbers of patients included for most indications.

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“…The fact that it is directly extracted through the urine without being metabolized in the body strongly suggested that transurethral administration of FOF would be more beneficial than the oral application to a certain extent 17. A number of studies have reported on the use of fosfomycin for prophylactic purposes in patients before surgical interventions 18–23. Among these, the ones employing prophylactic oral FOF administration reported infection prevention success as 88.6% to 100% following transurethral resection of the prostate and urological interventions for diagnostic or treatment purposes 20.…”

Section: Discussionmentioning

confidence: 99%

The preventive role of transurethral antibiotic delivery in a rat model

Özok¹,

Ekim²,

Saltas³

et al. 2012

DDDT

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PurposeThere is currently an emerging need for developing improved approaches for preventing urinary tract infections (UTIs) occurring during diagnostic or interventional procedures of the lower urinary tract. We aimed to establish a rat model to assess the use of transurethral antibiotic administration and to provide evidence that this could be used as a preventive therapy.MethodsAnimals received fosfomycin trometamol (FOF) either urethrally or orally prior to the procedure. A third group was generated as treatment controls and did not receive any medication. Urethral dilation was conducted to recapitulate an interventional procedure prior to intravesical Escherichia coli administration in all three groups. Finally, sham-operated animals were introduced as a fourth group which did not receive antibiotics or E. coli. Colony counts of urine and tissue cultures for the identification of E. coli and histopathological examinations of the bladder and prostate were conducted.ResultsEvaluation of infection intensities in cultures as well as histopathological examination of the bladder and prostate demonstrated a preventative role of transurethral FOF administration. In terms of efficiency, local administration of FOF was similar to oral administration.ConclusionsThese results suggest that transurethral antibiotic administration is a promising alternative for preventing UTIs occurring during diagnostic or interventional procedures of the lower urinary tract.

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Prophylactic chemotherapy with fosfomycin trometamol during transurethral surgery and urological manœuvres. Results of a multicentre study

Cited by 16 publications

References 8 publications

Japanese guidelines for prevention of perioperative infections in urological field

Japanese guidelines for prevention of perioperative infections in urological field

Fosfomycin Trometamol (3,000 mg) in Perioperative Antibiotic Prophylaxis of Healthcare-Associated Infections after Endourological Interventions: A Narrative Review

The preventive role of transurethral antibiotic delivery in a rat model

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