抗生素對經尿道前列腺切除術后菌尿預防效果的系統評價_《中國循證醫學雜志》

作者：

吳建臣 ¹ , 魏強 ¹ , 楊宇如 ¹ , 劉關鍵 ² , 盧一平 ¹

1. 四川大學華西醫院泌尿科,成都,6100412. 四川大學華西臨床醫學院,臨床流行病學教研室;

關鍵詞：

前列腺增生癥經尿道前列腺切除術抗生素預防治療系統評價

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目的　探討術前為清潔尿準備行經尿道前列腺切除術(transurethral resection of prostate,TURP)的患者,預防性應用抗生素對術后菌尿的預防是否有效.
方法　按Cochrane協作網工作手冊的要求,制定相應的納入標準、排除標準及檢索策略,檢索美國醫學索引、荷蘭醫學文摘藥理學分冊、中國生物醫學文摘及Cochrane圖書館的隨機對照試驗文獻.對收集的文獻按循證醫學的原則和方法進行評價,資料按統一的表格進行提取,應用RevMan軟件進行數據處理.
結果　共檢索到相關文獻53篇,其中符合納入標準的有27篇、排除26篇.Meta-分析結果表明,對于術前為清潔尿的患者,預防性應用抗生素能顯著降低TURP術后1周內菌尿的發生率,RR合并=0.36,95%CI(0.28,0.46).
結論　對于術前為清潔尿的患者,預防性應用抗生素能減少TURP術后菌尿的發生率,但抗生素的最佳應用方案及成本-效果分析尚需進一步研究.

引用本文： 吳建臣,魏強,楊宇如,劉關鍵,盧一平. 抗生素對經尿道前列腺切除術后菌尿預防效果的系統評價. 中國循證醫學雜志, 2004, 04(2): 98-103. doi: 復制

1.	［1］Holtgrewe HL. Current trends in management of men with lower urinary tract symptoms and benign prostatic hyperplasia[J]. Urology, 1998; 51(Suppl 4A):1-7.
2.	［2］Mebust WK, Holtgrewe HL, Cockett AT, Peters PC.Transurethral prostatectomy: immediate and postoperative complications. Cooperative study of 13 participating institutions evaluating 3 885 patients[J]. J Urol., 2002; 167(1) :5-9.
3.	［3］Mulrow CD, Oxman AD. The Cochrane Collaboration handbook, Issue 1,2000,Oxford,Update Software.
4.	［4］Bannister G, Arkell DG and Menday AP. Prostatectomy and prophylaxis[J]. J Antimicrob Chemother, 1981; 7 (2): 209-210.
5.	［5］Botto H, Richard F, Mathieu F, Perreau AM, Camey M.Short-Vterm proohylaxis with cefotaxime in prostatic surgery[J]. J Antimicrob Chemother, 1984; 14 (Suppl B) :231-235.
6.	［6］Charton M, Dosne B, Escovar P, Kopf A, Brisset JM. Single Vdose preventive treatment of urinary tract infections after endoscopic resection of the prostate [J ]. Presse Med., 1984;13(9): 545-548.
7.	［7］Charton M, Vallancien G, Veillon B, Brisset JM. Antibiotic prophylaxis of urinary tract infection after transurethral resection of the prostate: A randomized study[J]. J Urol., 1987; 138(1) :87-89.
8.	［8］Conn IG, Moffat LE. Short-term cephradine prophylaxis in elective transurethral prostatectomy [ J ]. J Hosp Infect, 1988;11 (4): 373-375.
9.	［9］Desai KM, Abrams PH, White LO. A double Vblind comparative trial of short Vterm orally administered enoxacin in the prevention of urinary infection after elective transurethral prostatectomy: A clinical and pharmacokinetic study [J ]. J Urol., 1988; 139(6):1232V1234.
10.	［10］Fair WB. Perioperative use of carbenicillin in transurethral resection ofprostate[J]. J Urol., 1986;272 (Suppl 1) :15-18.
11.	［11］Ferrie BG, Scott R. Prophylactic Cefuroxime in transurethral resection[J]. Urol Res, 1984 ;12 (6): 279-281.
12.	［12］Finkelstein LH, Arsht DB, Manfrey SJ, Childs S. Ceftriaxone in the prevention of postoperative infection in patients undergoing transurethral resection of the prostate [ J ]. Am J Surg, 1984;19(4A): 19-21.
13.	［13］Gibbons RP, Stark RA, Correa RJJr, Cummings KB,Mason JT. The prophylactic use-or misuse-of antibiotics in transurethral prostatectomy[J]. J Urol., 1978 ;119(3): 381-383.
14.	［14］Gonzalez R, Wright R, Blackard CE. Prophylactic antibiotics in transurethral prostatectomy[J ]. J Urol., 1976; 116 (2) :203-205.
15.	［15］Hargreave TB, Botto H, Rikken GH, Hindmarsh JR,Mc Dermott TE, Mjolnerod OK,Petays P, Schalkhauser HK,Stellos A. European collaborative study of antibiotic prophylaxis for transurethral resection of the prostate[J ]. Eur Urol, 1993; 23(4): 437443.
16.	［16］Harvey MH, Leese T, Lloyd D, Osborn DE. Antibiotic prophylaxis and secondary haemorrhage following transurethral resection of the prostate: a prospective trial [J ]. Br J Urol.,1986; 58(4): 450-452.
17.	［17］Holl WH, Rous SN. Is antibiotic prophylaxis worthwhile in patients with transurethral resection of prostate[J] ? Urology,1982 ;19(1): 43-46.
18.	［18］Houle AM, Mokhless I, Sarto N, Elhilali MM. Perioperative antibiotic prophylaxis for transurethral resection of the prostate:is it justifiable[J] ? J Urol., 1989; 142(2 pt 1): 317-319.
19.	［19］Matthew AD, Gonzalez R, Jeffords D, Pinto MH. Prevention of bactefiuria after transurethral prostatectomy with nitrofurantoin macrocrystals[J ]. J Urol., 1978; 120 (4):442-443.
20.	［20］Morris MJ, Golovsky D, Guinness MD, Maher PO. The value of prophylactic antibiotics in tranurethral prostatic resection: a controlled trial, with observations on the origin of postoperative infection [J ]. Br J Urol., 1976; 48 (6):479V484.
21.	［21］Nielsen OS, Maigaard S, Frimodt-Moller N, Madsen PO.Prophylatic antibiotics in transurethral prostatectomy [ J ]. J Urol., 1981 ;126(1) :60-62.
22.	［22］Qvist N, Christiansen HM, Ehlers D. Prophylactic antibiotics in transurethral prostatectomy[J ]. Urol Res, 1984; 12 (6) :275-277.
23.	［23］Raz R, Almog D, Elhanan G, Shental J. The use of ceftriaxone in the prevention of urinary tract infection in patients undergoing transurethral resection of the prostate (TUR-P)[J]. Infection, 1994; 22(5): 347-349.
24.	［24］Rocca Rossetti S, Boccafoschi C, Pellegrini A, Campo B,Rigatti P, Bono A,Ventriglia L. Aztreonam Hmonotherapy as prophylaxis in transurethral resection of the prostate: a multicentre study [ J ]. Rev Infect Dis, 1991; 13 (Suppl 7):626-628.
25.	［25］Scholz M, Luftenegger W, Hanmuth H, Wolf D, Holtl W.Single-dose antibiotic prophylaxis in transurethral resection of the prostate: a prospective randomized trial[ J ]. Br J Urol.,1998; 81 (6): 827-329.
26.	［26］Slavis SA, Miller JB, Golji H, Dunshee CJ. Comparison of single-dose antibiotic prophylaxis in uncomplicated transurethral resection of the prostate [ J ]. J Urol., 1992; 147 (5): 1303-1306.
27.	［27］Stricker PD, Grant AB. Relative value of antibiotics and catheter care in the prevention of urinary tract infection after transurethral prostatic resection [J]. Br J Urol., 1988; 61(6): 494-497.
28.	［28］Taylor EW, Lindsay G. Antibiotic prophylaxis in transurethral resection of the prostate with reference to the influence of preoperative catheterization [J ]. J Hosp Infect. 1988; 12 (2):75-83.
29.	［29］Viitanen J, Talja M, Jussila E, Nurmi M, Permi J, Puolakka VM, Rintala E, Salmela H, Tiitinen J, Tuhkanen K.Randomized controlled study of chemoprophylaxis in transurethral prostatectomy[J]. J Urol., 1993; 1505 (Pt 2):1715-1717.
30.	［30］Weiss J, Wein A, Jacobs J, Hanno P. Use of nitrofurantoin macrocrystals after transurethral prostatectomy [ J ]. J Urol.,1983; 130(3) :479-480.
31.	［31］Robinson MR, Arudpragasam ST, Sahgal SM, Cross RJ,Akdas A, Fittal B, Sibbald R. Bacteremia resulting from prostatic surgery: The sourse of bacteria [ J ]. Br. J Urol.,1982; 54(5): 542-546.
32.	［32］Grabe M. Short antibiotic courses in transurethral prostatic resection. Scand J Urol. Nephrol, 1984 ;78 (1) :4.
33.	［33］Wear JB, Haley P. transurethral prostatectomy without antibiotics[J]. J Urol., 1973; 110(4): 436-440.
34.	［34］Robinson MR, Cross RJ, Shetty MB, Fittall B. Bacteraemia and bacteriogenic shock in district hospital urologocal practice[J]. Br J Urol., 1980; 52(1): 10-14.
35.	［35］Balbay MD, Ergen A, Sahin A, Lekili M, Ulucay S,Karaagaoglu E. Development of urethral stricture after transurethral prostatectomy: a retrospective study [ J ]. Int Urol. Nephol, 1992; 24(1): 49-53.

1. ［1］Holtgrewe HL. Current trends in management of men with lower urinary tract symptoms and benign prostatic hyperplasia[J]. Urology, 1998; 51(Suppl 4A):1-7.
2. ［2］Mebust WK, Holtgrewe HL, Cockett AT, Peters PC.Transurethral prostatectomy: immediate and postoperative complications. Cooperative study of 13 participating institutions evaluating 3 885 patients[J]. J Urol., 2002; 167(1) :5-9.
3. ［3］Mulrow CD, Oxman AD. The Cochrane Collaboration handbook, Issue 1,2000,Oxford,Update Software.
4. ［4］Bannister G, Arkell DG and Menday AP. Prostatectomy and prophylaxis[J]. J Antimicrob Chemother, 1981; 7 (2): 209-210.
5. ［5］Botto H, Richard F, Mathieu F, Perreau AM, Camey M.Short-Vterm proohylaxis with cefotaxime in prostatic surgery[J]. J Antimicrob Chemother, 1984; 14 (Suppl B) :231-235.
6. ［6］Charton M, Dosne B, Escovar P, Kopf A, Brisset JM. Single Vdose preventive treatment of urinary tract infections after endoscopic resection of the prostate [J ]. Presse Med., 1984;13(9): 545-548.
7. ［7］Charton M, Vallancien G, Veillon B, Brisset JM. Antibiotic prophylaxis of urinary tract infection after transurethral resection of the prostate: A randomized study[J]. J Urol., 1987; 138(1) :87-89.
8. ［8］Conn IG, Moffat LE. Short-term cephradine prophylaxis in elective transurethral prostatectomy [ J ]. J Hosp Infect, 1988;11 (4): 373-375.
9. ［9］Desai KM, Abrams PH, White LO. A double Vblind comparative trial of short Vterm orally administered enoxacin in the prevention of urinary infection after elective transurethral prostatectomy: A clinical and pharmacokinetic study [J ]. J Urol., 1988; 139(6):1232V1234.
10. ［10］Fair WB. Perioperative use of carbenicillin in transurethral resection ofprostate[J]. J Urol., 1986;272 (Suppl 1) :15-18.
11. ［11］Ferrie BG, Scott R. Prophylactic Cefuroxime in transurethral resection[J]. Urol Res, 1984 ;12 (6): 279-281.
12. ［12］Finkelstein LH, Arsht DB, Manfrey SJ, Childs S. Ceftriaxone in the prevention of postoperative infection in patients undergoing transurethral resection of the prostate [ J ]. Am J Surg, 1984;19(4A): 19-21.
13. ［13］Gibbons RP, Stark RA, Correa RJJr, Cummings KB,Mason JT. The prophylactic use-or misuse-of antibiotics in transurethral prostatectomy[J]. J Urol., 1978 ;119(3): 381-383.
14. ［14］Gonzalez R, Wright R, Blackard CE. Prophylactic antibiotics in transurethral prostatectomy[J ]. J Urol., 1976; 116 (2) :203-205.
15. ［15］Hargreave TB, Botto H, Rikken GH, Hindmarsh JR,Mc Dermott TE, Mjolnerod OK,Petays P, Schalkhauser HK,Stellos A. European collaborative study of antibiotic prophylaxis for transurethral resection of the prostate[J ]. Eur Urol, 1993; 23(4): 437443.
16. ［16］Harvey MH, Leese T, Lloyd D, Osborn DE. Antibiotic prophylaxis and secondary haemorrhage following transurethral resection of the prostate: a prospective trial [J ]. Br J Urol.,1986; 58(4): 450-452.
17. ［17］Holl WH, Rous SN. Is antibiotic prophylaxis worthwhile in patients with transurethral resection of prostate[J] ? Urology,1982 ;19(1): 43-46.
18. ［18］Houle AM, Mokhless I, Sarto N, Elhilali MM. Perioperative antibiotic prophylaxis for transurethral resection of the prostate:is it justifiable[J] ? J Urol., 1989; 142(2 pt 1): 317-319.
19. ［19］Matthew AD, Gonzalez R, Jeffords D, Pinto MH. Prevention of bactefiuria after transurethral prostatectomy with nitrofurantoin macrocrystals[J ]. J Urol., 1978; 120 (4):442-443.
20. ［20］Morris MJ, Golovsky D, Guinness MD, Maher PO. The value of prophylactic antibiotics in tranurethral prostatic resection: a controlled trial, with observations on the origin of postoperative infection [J ]. Br J Urol., 1976; 48 (6):479V484.
21. ［21］Nielsen OS, Maigaard S, Frimodt-Moller N, Madsen PO.Prophylatic antibiotics in transurethral prostatectomy [ J ]. J Urol., 1981 ;126(1) :60-62.
22. ［22］Qvist N, Christiansen HM, Ehlers D. Prophylactic antibiotics in transurethral prostatectomy[J ]. Urol Res, 1984; 12 (6) :275-277.
23. ［23］Raz R, Almog D, Elhanan G, Shental J. The use of ceftriaxone in the prevention of urinary tract infection in patients undergoing transurethral resection of the prostate (TUR-P)[J]. Infection, 1994; 22(5): 347-349.
24. ［24］Rocca Rossetti S, Boccafoschi C, Pellegrini A, Campo B,Rigatti P, Bono A,Ventriglia L. Aztreonam Hmonotherapy as prophylaxis in transurethral resection of the prostate: a multicentre study [ J ]. Rev Infect Dis, 1991; 13 (Suppl 7):626-628.
25. ［25］Scholz M, Luftenegger W, Hanmuth H, Wolf D, Holtl W.Single-dose antibiotic prophylaxis in transurethral resection of the prostate: a prospective randomized trial[ J ]. Br J Urol.,1998; 81 (6): 827-329.
26. ［26］Slavis SA, Miller JB, Golji H, Dunshee CJ. Comparison of single-dose antibiotic prophylaxis in uncomplicated transurethral resection of the prostate [ J ]. J Urol., 1992; 147 (5): 1303-1306.
27. ［27］Stricker PD, Grant AB. Relative value of antibiotics and catheter care in the prevention of urinary tract infection after transurethral prostatic resection [J]. Br J Urol., 1988; 61(6): 494-497.
28. ［28］Taylor EW, Lindsay G. Antibiotic prophylaxis in transurethral resection of the prostate with reference to the influence of preoperative catheterization [J ]. J Hosp Infect. 1988; 12 (2):75-83.
29. ［29］Viitanen J, Talja M, Jussila E, Nurmi M, Permi J, Puolakka VM, Rintala E, Salmela H, Tiitinen J, Tuhkanen K.Randomized controlled study of chemoprophylaxis in transurethral prostatectomy[J]. J Urol., 1993; 1505 (Pt 2):1715-1717.
30. ［30］Weiss J, Wein A, Jacobs J, Hanno P. Use of nitrofurantoin macrocrystals after transurethral prostatectomy [ J ]. J Urol.,1983; 130(3) :479-480.
31. ［31］Robinson MR, Arudpragasam ST, Sahgal SM, Cross RJ,Akdas A, Fittal B, Sibbald R. Bacteremia resulting from prostatic surgery: The sourse of bacteria [ J ]. Br. J Urol.,1982; 54(5): 542-546.
32. ［32］Grabe M. Short antibiotic courses in transurethral prostatic resection. Scand J Urol. Nephrol, 1984 ;78 (1) :4.
33. ［33］Wear JB, Haley P. transurethral prostatectomy without antibiotics[J]. J Urol., 1973; 110(4): 436-440.
34. ［34］Robinson MR, Cross RJ, Shetty MB, Fittall B. Bacteraemia and bacteriogenic shock in district hospital urologocal practice[J]. Br J Urol., 1980; 52(1): 10-14.
35. ［35］Balbay MD, Ergen A, Sahin A, Lekili M, Ulucay S,Karaagaoglu E. Development of urethral stricture after transurethral prostatectomy: a retrospective study [ J ]. Int Urol. Nephol, 1992; 24(1): 49-53.

《中國循證醫學雜志》

抗生素對經尿道前列腺切除術后菌尿預防效果的系統評價

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

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《中國循證醫學雜志》

抗生素對經尿道前列腺切除術后菌尿預防效果的系統評價

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

摘要全文圖表視頻參考文獻施引文獻補充材料