title: Analysis of isolated bacteria and short-term antimicrobial prophylaxis with tazobactam-piperacillin (1:4 ratio) for prevention of postoperative infections after radical cystectomy.
abstract: Radical cystectomy is associated with the highest morbidity and mortality of all commonly performed urological cancer treatment procedures. Postoperative infection remains a major problem. We herein report the results of an open prospective study involving radical cystectomies, undertaken to evaluate the efficacy of 0.5/2 g tazobactam-piperacillin (TAZ-PIPC) in the prevention of postoperative infectious complications. Antimicrobial prophylaxis was performed using 0.5/2 g TAZ-PIPC (2.5 g i.v.) every 3 h during surgery and then twice a day for 3 days postoperatively. The patients were monitored to detect any postoperative infections. During surgery, irrigation fluid from the total abdominal cavity was taken for bacterial culture just before closing the abdomen. Surveillance cultures of drain discharge and urine from ureteral stents were also performed. Other samples were taken for bacterial culture when an infection was suspected. The total postoperative bacterial infection rate was 20.0% (7/35), and surgical site infection rate was 5.7% (2/35). These rates are lower than those documented in other studies. This study, even though open and noncomparative, showed that a short-interval regimen containing 0.5/2 g TAZ-PIPC provides adequate antimicrobial prophylaxis in patients undergoing radical cystectomy.
authors: Division of Urology, Department of Surgery Related, Kobe University Graduate School of Medicine, 7-5-1 Kusunokicho, Chuoku, Kobe 650-0017, Japan. kazushi@med.kobe-u.ac.jp
authors: Kazushi
authors: K
authors: Tanaka
authors: Soichi
authors: S
authors: Arakawa
authors: Tetsuya
authors: T
authors: Miura
authors: Katsumi
authors: K
authors: Shigemura
authors: Yuzo
authors: Y
authors: Nakano
authors: Satoshi
authors: S
authors: Takahashi
authors: Taiji
authors: T
authors: Tsukamoto
authors: Tetsuro
authors: T
authors: Matsumoto
authors: Masato
authors: M
authors: Fujisawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D001419:Bacteria / Q000145:classification / Q000187:drug effects / Q000302:isolation & purification*; D001424:Bacterial Infections / Q000382:microbiology / Q000517:prevention & control; D015653:Cystectomy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D010397:Penicillanic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D010878:Piperacillin / Q000627:therapeutic use; D000077725:Piperacillin, Tazobactam Drug Combination; D013530:Surgical Wound Infection / Q000382:microbiology / Q000517:prevention & control*; D016896:Treatment Outcome; D014552:Urinary Tract Infections / Q000382:microbiology / Q000517:prevention & control*
chemical_list: D000900:Anti-Bacterial Agents; D000077725:Piperacillin, Tazobactam Drug Combination; D010397:Penicillanic Acid; D010878:Piperacillin