title: Assessment of antimicrobial prophylaxis to prevent perioperative infection in patients undergoing prostate brachytherapy: multicenter cohort study.
abstract: To propose an appropriate prophylactic antimicrobial therapy for patients undergoing brachytherapy, we evaluated the relationships between various antimicrobial prophylaxis (AMP) protocols and the incidence of postimplant infections in a multicenter cohort study conducted in Japan. The records of 826 patients with localized prostate cancer who underwent a transperineal (125)I brachytherapy procedure between January 2009 and December 2010 were retrospectively reviewed. Perioperative infections, including surgical site and remote infections, were recorded up to postoperative day 30. A total of 6 (0.73%) patients had a perioperative infection following seed implantation, of whom all received AMP for 1 or more days. None of the patients who received a single-dose protocol of AMP using fluoroquinolone p.o. or penicillin with a beta-lactamase inhibitor i.v. developed a perioperative infection. Statistical analysis showed that a single-dose protocol was more significantly related to a lower risk of perioperative infection as compared to the other AMP protocols examined (p = 0.045). Furthermore, our results indicated that bacteriuria and preoperative hair removal were risk factors of perioperative infection with statistical significance (p = 0.007, p = 0.004). Analysis of patient clinical parameters, including age, American Society of Anesthesiologists score, diabetes mellitus, prostate volume, numbers of implanted seeds and needle punctures, operation time, and indwelling duration time of the Foley catheter, did not reveal significant differences in terms of perioperative infection. Our results indicated that a single-dose AMP protocol is sufficient to prevent perioperative infections following seed implantation. On the other hand, AMP is only one of several measures to prevent perioperative infectious complications. It is necessary to know that the patient must have no bacteriuria and that preoperative hair removal should be avoided.
authors: Department of Urology, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan, rikiya0910@yahoo.co.jp.
authors: Rikiya
authors: R
authors: Taoka
authors: Yoshikazu
authors: Y
authors: Togo
authors: Tatsuhiko
authors: T
authors: Kubo
authors: Masahito
authors: M
authors: Kido
authors: Kenta
authors: K
authors: Miki
authors: Hiroshi
authors: H
authors: Kiyota
authors: Shin
authors: S
authors: Egawa
authors: Takashi
authors: T
authors: Sugawara
authors: Mitsuru
authors: M
authors: Yasuda
authors: Masahiro
authors: M
authors: Nakano
authors: Takashi
authors: T
authors: Deguchi
authors: Masashi
authors: M
authors: Nishino
authors: Kiyohito
authors: K
authors: Ishikawa
authors: Ryoichi
authors: R
authors: Shiroki
authors: Minori
authors: M
authors: Matsumoto
authors: Katsumi
authors: K
authors: Shigemura
authors: Kazushi
authors: K
authors: Tanaka
authors: Soichi
authors: S
authors: Arakawa
authors: Masato
authors: M
authors: Fujisawa
authors: Koichiro
authors: K
authors: Wada
authors: Toyohiko
authors: T
authors: Watanabe
authors: Hiromi
authors: H
authors: Kumon
authors: Kanao
authors: K
authors: Kobayashi
authors: Akio
authors: A
authors: Matsubara
authors: Takehiko
authors: T
authors: Sho
authors: Ryoichi
authors: R
authors: Hamasuna
authors: Tetsuro
authors: T
authors: Matsumoto
authors: Hiroshi
authors: H
authors: Hayami
authors: Masayuki
authors: M
authors: Nakagawa
authors: Shingo
authors: S
authors: Yamamoto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D001424:Bacterial Infections / Q000188:drug therapy / Q000517:prevention & control*; D001918:Brachytherapy / Q000009:adverse effects* / Q000379:methods*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000188:drug therapy / Q000517:prevention & control; D011471:Prostatic Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents