title: Clinical effectiveness and safety of tazobactam/piperacillin 4.5 g for the prevention of febrile infectious complication after prostate biopsy.
abstract: We investigated the clinical effectiveness and safety of tazobactam/piperacillin (TAZ/PIPC) in a 1:8 ratio, a β-lactamase inhibitor with penicillin antibiotic, for the prevention of febrile infectious complication after prostate biopsy. Each patient received a single dose of TAZ/PIPC 4.5 g, 30 min before the biopsy in Group 1 or TAZ/PIPC 4.5 g twice, once 30 min before and once after the biopsy (just before discharge or 5 h after the biopsy), in Group 2. Estimation of efficacy was performed within 1-month after prostate biopsy. Clinical diagnosis of febrile infectious complication was based on a body temperature elevation greater than 38 °C. Infectious complication after prostate biopsy was detected in 2.5% (4/160 patients) in Group 1 and in 0.45% (2/442 patients) in Group 2. All of the patients with febrile infectious complication had risk factors: 5 patients had voiding disturbance, 2 patients had diabetes mellitus and 1 patient had steroid dosing. In group 1, 88 patients had at least one risk factor and 72 patients had no risk factors. Of the patients with a risk factor, 4 had febrile infectious complication after prostate biopsy, but there was no significant difference between the two groups. In group 2, 87 patients had at least one risk factor and 255 patients had no risk factors. The patients with a risk factor had febrile infectious complication significantly more frequently than did patients without a risk factor (P = 0.038). Therefore, TAZ/PIPC appears to be effective as preoperative prophylaxis against the occurrence of febrile infectious complication after prostate biopsy.
authors.affiliation: Department of Urology, Gifu University Hospital, Japan; Japanese Research Group for Urinary Tract Infection, Japan. Electronic address: super7@gifu-u.ac.jp.
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Yasuda
authors.affiliation: Department of Urology, Gifu University Hospital, Japan.
authors.forename: Keita
authors.initials: K
authors.lastname: Nakane
authors.affiliation: Department of Urology, Gifu University Hospital, Japan.
authors.forename: Yoshiteru
authors.initials: Y
authors.lastname: Yamada
authors.affiliation: Department of Urology, University of Occupational and Environmental Health, Japan; Japanese Research Group for Urinary Tract Infection, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Matsumoto
authors.affiliation: Department of Urology, University of Occupational and Environmental Health, Japan; Japanese Research Group for Urinary Tract Infection, Japan.
authors.forename: Takehiko
authors.initials: T
authors.lastname: Sho
authors.affiliation: Division of Urology, Kobe University Graduate School of Medicine, Japan; Japanese Research Group for Urinary Tract Infection, Japan.
authors.forename: Minori
authors.initials: M
authors.lastname: Matsumoto
authors.affiliation: Department of Urology, Chugoku Rosai Hospital, Japan Labour Health and Welfare Organization, Japan; Japanese Research Group for Urinary Tract Infection, Japan.
authors.forename: Kanao
authors.initials: K
authors.lastname: Kobayashi
authors.affiliation: Department of Urology, Shinko Hospital, Japan; Japanese Research Group for Urinary Tract Infection, Japan.
authors.forename: Katsumi
authors.initials: K
authors.lastname: Shigemura
authors.affiliation: Division of Urology, Kobe University Graduate School of Medicine, Japan; Japanese Research Group for Urinary Tract Infection, Japan.
authors.forename: Yuzo
authors.initials: Y
authors.lastname: Nakano
authors.affiliation: Division of Urology, Kobe University Graduate School of Medicine, Japan; Japanese Research Group for Urinary Tract Infection, Japan.
authors.forename: Kazushi
authors.initials: K
authors.lastname: Tanaka
authors.affiliation: Department of Urology, University of Occupational and Environmental Health, Japan; Japanese Research Group for Urinary Tract Infection, Japan.
authors.forename: Ryoichi
authors.initials: R
authors.lastname: Hamasuna
authors.affiliation: Department of Urology, Kizawa Memorial Hospital, Japan; Japanese Research Group for Urinary Tract Infection, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ishihara
authors.affiliation: Division of Urology, Kobe University Graduate School of Medicine, Japan; Japanese Research Group for Urinary Tract Infection, Japan.
authors.forename: Soichi
authors.initials: S
authors.lastname: Arakawa
authors.affiliation: Department of Urology, Hyogo College of Medicine, Japan; Japanese Research Group for Urinary Tract Infection, Japan.
authors.forename: Shingo
authors.initials: S
authors.lastname: Yamamoto
authors.affiliation: Department of Urology, Hiroshima University Institute of Biomedical and Health Sciences, Japan; Japanese Research Group for Urinary Tract Infection, Japan.
authors.forename: Akio
authors.initials: A
authors.lastname: Matsubara
authors.affiliation: Division of Urology, Kobe University Graduate School of Medicine, Japan; Japanese Research Group for Urinary Tract Infection, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Fujisawa
authors.affiliation: Department of Urology, Gifu University Hospital, Japan; Japanese Research Group for Urinary Tract Infection, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Deguchi
authors.affiliation: Department of Urology, University of Occupational and Environmental Health, Japan; Japanese Research Group for Urinary Tract Infection, Japan.
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Matsumoto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000009:adverse effects; D019072:Antibiotic Prophylaxis / Q000379:methods*; D001707:Biopsy, Needle / Q000009:adverse effects; D001831:Body Temperature; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000009:adverse effects; D005334:Fever / Q000382:microbiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010397:Penicillanic Acid / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D010878:Piperacillin / Q000008:administration & dosage / Q000009:adverse effects; D000077725:Piperacillin, Tazobactam Drug Combination; D011446:Prospective Studies; D011467:Prostate / Q000473:pathology*; D011469:Prostatic Diseases / Q000150:complications / Q000382:microbiology / Q000517:prevention & control*; D012307:Risk Factors; D014552:Urinary Tract Infections / Q000150:complications / Q000517:prevention & control*
chemical_list: D000900:Anti-Bacterial Agents; D000077725:Piperacillin, Tazobactam Drug Combination; D010397:Penicillanic Acid; D010878:Piperacillin
keywords: Infectious complication; Prophylaxis; Prostate biopsy; Tazobactam/piperacillin