[Use of levofloxacin in the antibiotic prophylaxis for diagnostic procedures in urology].
Chemoprophylaxis is the use of antimicrobial agents before contamination in the hope of preventing infections. The need for prophylaxis depends on the type of procedure and the risk for each individual patient. The risk for infection from urethral catheterization in a hospital setting is 5% for men and 10-20% for women, after routine cystoscopy is 4.7%, after transurethral resection of the bladder (TURB) is 39%, after transurethral resection of the prostate (TURP) is 6-43%, after transrectal biopsy of the prostate is 6.2-87%, and after shock wave lithotripsy is 5.7%. On this basis prophylactic treatment is recommended in all patients for transrectal prostate biopsy and transurethral surgery and in patients with increased risk of infection for diagnostic endoscopy of the urinary tract and SWL. Risk factors such as age, immunosuppression, metabolic dysfunction (e.g., diabetes), reduced general condition, prolonged operative time and bleeding, should be considered. Broad-spectrum cephalosporin, penicillins and fluoroquinolones are most often used. The choice of the drug also depends on its pharmacokinetic properties that should secure effective tissue levels during the procedure. Levofloxacin meets these criteria and reduces the incidence of infection after transrectal prostate biopsy and endoscopy of the urinary tract.
Trinchieri
Alberto
A
Clinica Urologica, IRCCS Ospedale Maggiore di Milano.
Mangiarotti
Barbara
B
Lizzano
Renata
R
D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000892:Anti-Infective Agents, Urinary / Q000008:administration & dosage / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000453:epidemiology / Q000517:prevention & control*; D001437:Bacteriuria / Q000453:epidemiology / Q000517:prevention & control; D001706:Biopsy; D015897:Comorbidity; D003950:Diagnostic Techniques, Urological; D004198:Disease Susceptibility; D004341:Drug Evaluation; D004724:Endoscopy; D004866:Equipment Contamination; D006801:Humans; D015994:Incidence; D064704:Levofloxacin; D008096:Lithotripsy; D008297:Male; D008875:Middle Aged; D015242:Ofloxacin / Q000008:administration & dosage / Q000627:therapeutic use*; D011292:Premedication; D011446:Prospective Studies; D011467:Prostate / Q000473:pathology; D012307:Risk Factors; D014546:Urinary Catheterization; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000517:prevention & control*
D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D000892:Anti-Infective Agents, Urinary; D064704:Levofloxacin; D015242:Ofloxacin
Impiego della levofloxacina nella profilassi antibiotica per manovre diagnostiche in urologia.