[Antibacterial prophylaxis in endourological procedures].
OBJECTIVE
Antibiotic prophylaxis for the prevention of postsurgical infections is a common practice in urologic surgery, as well as in endourologic procedures, both in at risk patients (local or systemic risk factors: age, immunological status, metabolic disorders, poor general conditions) or with a positive urine culture, but also in patients with urine previously sterile. As Gram-negative strains are the most common pathogens, it is reasonable to use a quinolone or a beta-lactam.


METHODS
One-hundred and thirty-one patients (range 21-89 years) underwent transurethral cystoscopy (52 cases), vesical catheterism (44 cases), extracorporeal shockwave lithotripsy (17 cases) and transrectal prostatic biopsy (18 cases). An antimicrobial prophylaxis with ciprofloxacin 500 mg (22 patients, 16.8%), levofloxacin 500 mg (54 patients, 41.2%) and prulifloxacin 600 mg (55 patients, 42%) was administered.


RESULTS
Globally, the incidence of urinary tract infections during 15 days after surgery was 8.4% (11 cases out of 131): ciprofloxacin 9.1%, levofloxacin 11.1% and prulifloxacin 5.5%, respectively. The patients compliance with the prophylactic treatment was good or excellent in 122 cases (93.1%) and poor in 9 cases (6.9%). No major differences between antibiotics used in prophylaxis were detected, keeping into account the limited size of the global population and subgroups defined by the endourological procedures.


CONCLUSIONS
Prulifoxacin, with a broad antimicrobial spectrum, favourable pharmacokinetic properties and easy to use, can be considered a valid and well tolerated therapeutic option for the antibacterial prophylaxis in endourological procedures, both in hospital and in outpatient setting.
Prezioso
D
D
Dipartimento Scienze Ginecologiche ed Urologiche, Università degli Studi Federico II, Napoli, Italy. dprezioso@libero.it
Bartoletti
R
R
Damiano
R
R
Morgia
G
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019072:Antibiotic Prophylaxis; D001706:Biopsy / Q000009:adverse effects; D003558:Cystoscopy / Q000009:adverse effects; D005260:Female; D006801:Humans; D008096:Lithotripsy / Q000009:adverse effects; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000382:microbiology* / Q000517:prevention & control*; D011467:Prostate / Q000473:pathology; D014546:Urinary Catheterization / Q000009:adverse effects; D013520:Urologic Surgical Procedures / Q000009:adverse effects*