[Effect of flash chemoprophylaxis by cefotaxime on the appearance of postoperative bacterial superinfections in surgery of the prostate].
The effect on bacteriologically documented postoperative infection of flash prophylaxis using two intravenous injections of 20 mg/kg cefotaxime each was evaluated in a double blind, randomized trial against placebo. 181 participants free of urinary tract infection prior to surgery had either transurethral prostatic resection (TUR) (n = 90) or open prostatectomy (OP) (n = 91). Urine samples, blood samples, prostate specimens and skin swabs were investigated for pathogens. Rate of urinary tract infection was significantly reduced by cefotaxime (CTX) prophylaxis in both groups. CTX lowered the incidence of early postoperative urinary tract infection from 30% to 4% in TURs and from 46% to 4.5% in OPs. Similarly, a significant difference was demonstrated for incidences of intra and postoperative bacteremia. In open prostatectomy patients, a reduced rate of wound infection and shorter hospital stay were noted in the treated group. Pathogens recovered in this study were Streptococcus (29%), Staphylococcus (20.5%), Enterobacteriaceae (45.75%), Pseudomonas (1.25%), Acinetobacter (3%), and Bacteroides fragilis (0.5%). CTX prophylaxis apparently has no bearing on postoperative emergence of resistant pathogens. Percentage of resistance to CTX in delayed postoperative infections was 33% in the control group and 35% in the treated group. We conclude that flash CTX prophylaxis in transurethral or open prostatectomy is of benefit in reducing morbidity and hospital costs.
D001424:Bacterial Infections / Q000209:etiology / Q000517:prevention & control*; D002439:Cefotaxime / Q000008:administration & dosage / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D004311:Double-Blind Method; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000517:prevention & control; D011467:Prostate / Q000601:surgery; D011468:Prostatectomy; D011469:Prostatic Diseases / Q000601:surgery*; D011897:Random Allocation; D018805:Sepsis / Q000517:prevention & control; D014552:Urinary Tract Infections / Q000517:prevention & control; D014946:Wound Infection / Q000517:prevention & control
D002439:Cefotaxime
Influence d'une chimioprophylaxie flash par le céfotaxime sur l'apparition de surinfections bactériennes post-opératoires dans la chirurgie de la prostate.