medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2022-16-6-68-73medsovet-6813Research ArticleУРОЛОГИЯUROLOGYПрименение фосфомицина в антибиотикопрофилактике инфекционных осложнений биопсии предстательной железыFosfomycin in antibiotic prophylaxis of infectious complications after biopsy of the prostatehttps://orcid.org/0000-0001-5721-0170ГригорьевН. А.GrigorievN. A.

д.м.н., профессор, руководитель клиники урологии,

129090, Москва, ул. Щепкина, д. 35

Dr. Sci. (Med.), Professor, Chief of the Clinic of Urology, 

35, Schepkin St., Moscow, 129090

grigna69@gmail.comhttps://orcid.org/0000-0001-5024-7982АбдуллинИ. И.AbdullinI. I.

к.м.н., врач-уролог клиники урологии,

129090, Москва, ул. Щепкина, д. 35

Cand. Sci. (Med.), Urologist of the Clinic of Urology,

35, Schepkin St., Moscow, 129090

iabdullin@emcmos.ruhttps://orcid.org/0000-0003-0787-5929ЛогиновА. В.LoginovA. V.

к.м.н., врач-терапевт клиники урологии, 

129090, Москва, ул. Щепкина, д. 35

Cand. Sci. (Med.), Doctor-therapist of the Clinic of Urology,

35, Schepkin St., Moscow, 129090

aloginov@emcmos.ruhttps://orcid.org/0000-0002-9443-1164ЖиляевЕ. В.ZhilyaevE. V.

 д.м.н., профессор, главный врач,

129090, Москва, ул. Щепкина, д. 35

Dr. Sci. (Med.), Professor, Head Physician, 

35, Schepkin St., Moscow, 129090

ezhilyaev@emcmos.ruЕвропейский Медицинский ЦентрРоссияEuropean Medical CenterRussian Federation202221042022066873Copyright © Григорьев Н.А., Абдуллин И.И., Логинов А.В., Жиляев Е.В., 20222022Григорьев Н.А., Абдуллин И.И., Логинов А.В., Жиляев Е.В.Grigoriev N.A., Abdullin I.I., Loginov A.V., Zhilyaev E.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/6813Введение

Введение. Несмотря на рекомендованные схемы антибиотикопрофилактики, инфекционно-воспалительные осложнения при биопсии простаты встречаются довольно часто.

Цель

Цель. Оценить эффективность комбинированной антибиотикопрофилактики препаратом фосфомицин и фторхинолонами 3-го поколения.

Материалы и методы

Материалы и методы. В исследовании приняли участие 80 пациентов, которые были разделены на 2 группы: в 1-й группе накануне перед выполнением трансректальной биопсии предстательной железы больным назначалась рутинная профилактика (прием Левофлоксацина в дозе 500 мг за 6 ч до выполнения биопсии и в течение 4-х дней после процедуры по 500 мг в день). Пациентам из 2-й группы наряду со стандартной профилактикой после биопсии был назначен однократный прием фосфомицина трометамола в дозе 3 г.

Результаты и  обсуждение

Результаты и  обсуждение. Инфекционно-воспалительные осложнения возникли в  1-й группе у  8  пациентов  (20%). 12,5%  пациентов 1-й группы потребовались госпитализация и  проведение парентеральной антибиотикотерапии. Средняя продолжительность пребывания в  стационаре составила 3,4  ±  1,45  дня. У  всех пациентов 1-й группы была выявлена кишечная палочка (E. coli), в 70% случаев получен фторхинолон-резистентный штамм бактерии. Во 2-й группе не было пациентов, требующих госпитализации. У одного больного из сорока (2,5%) человек данной группы были отмечены признаки инфекции мочевых путей, которые не сопровождались повышением температуры тела и изменениями в анализах крови и мочи.

Заключение

Заключение. Полученные результаты показывают высокую эффективность комбинированной антибиотикопрофилактики. Мы продолжаем наше исследование, т. к. в условиях роста фторхинолон-устойчивых штаммов необходимо применение альтернативных схем, а также проведение мониторинга внутрибольничной инфекции и контроля антимикробной терапии. 

Introduction

Introduction. Biopsy of prostate is a routine urologic procedure. More than 1 million biopsies are performed worldwide annually. The frequency of infectious-inflammatory complications remain high, despite the recommended antibiotic prophylaxis schemes.

Aim

Aim. The evaluation of  effectiveness and safety of  combined antimicrobial prophylaxis: Fosfomycin and Fluoroquinolones of 3rd generation.

Materials and methods

Materials and methods. 80 patients underwent prostate biopsy in our study and were divided into 2 groups: the first group of 40 patients received routine prophylaxis: Levofloxacin 500 mg 6 hours before the biopsy and 500 mg per day during 4 days after biopsy. The second group of 40 patients, along with standard prophylaxis as in the first group, additionally after biopsy received Fosfomycin 3 gr single-shot.

Results and discussion

Results and discussion. In the first group, infectious and inflammatory complications occurred in 8 patients (20%). 12.5% of patients from the first group were hospitalized for paranteral antibiotic therapy. The average length of stay in hospital was 3.4 ± 1.45 days. In all cases, in the first group of patients, E. coli was detected, in 70% of cases fluoroquinolone-resistant strain of the bacterium was received. In the second group of patients now hospitalization was required. One patient out of forty (2.5%) from this group showed signs of urinary tract infection, which was not accompanied by an increase of body temperature, as well as changes in blood and urine tests.

Conclusion

Conclusion. Our results show good effectiveness and safety of fosfomicin for antibiotic prophylaxis for transrectal prostate biopsy. 

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The authors declare that there are no conflicts of interest present.