PTU - Polskie Towarzystwo Urologiczne
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The prophylactic use of phosphomycin in endoscopic procedures associated urinary tract infections (UTI)
Article published in Urologia Polska 2002/55/1.

authors

Tomasz Szopiński, Artur A. Antoniewicz, Andrzej Borówka
Zespół Dydaktyki Urologicznej CMKP, Oddział Urologii Centralnego Szpitala Kolejowego w Warszawie Kierownik zespołu i ordynator oddziału: prof, dr hab. Andrzej Borówka

keywords

urinary tract, chemotherapy, endoscopic procedures, Monural®

summary

SUMMARY
Objective. The chemotherapy in patients undergoing endoscopic procedures remains a subject for discussion. However, many authors share the opinion prophylactic use of chemotherapeutic agents is recommended in TURP, PCNL and URSL
The study is aimed at evaluating the efficacy and safety of Monural® (phosphomycin) use in prevention of UTI among subjects qualified for endoscopic procedures.
Patients and Methods. Sixty patients were involved and splited into two groups: 30 men undergone TURP due to BPH (group I) and 30 individuals (11 males and 19 females) treated because of upper tract urolithiasis (group II). PCNL and URSL were carried out in 12 and 18 patients of group II, respectively. Results. Microbiological examination was performed in all patients immediately after all drainage catheter removal and in next 3-5 days. The follow-up in 2-3 weeks following procedure was completed in 53 (88,5%) individuals. Negative urine cultures were observed in 57 (95%) patients immediately after procedure and in 85% 2-3 weeks later. Adverse effects (diarrhoea) occurred in 13,3%.
Conclusions.
1. The clinical efficacy of Monural® in prevention of UTI in endoscopically treated patients is high, because the risk of secondary infection caused by hospital bacterial strains accounts for only 5%.
2. Monural® is safe. The only adverse effect produced by Monural® (in 13,3% of patients) was clinically insignificant diarrhoea.
3. Dose and administration of oral form of Monural® is comfortable for patients as well as for nurses.
4. Patients fully accept the oral form of Monural®.

references

  1. 1. Del Rio G, Dalel F. Chechile G: Antimicrobial prophylaxis in urologie surgery: does it give some benefit? Eur Urol 1993; 24; 305-311.
  2. 2. Ramsey EW, Sheth NK: Antibiotic prophylaxis in patients undergoing prostatectomy. Urology 1983; 21; 376-278.
  3. 3. Baert L, Billiel I, Vandepitte J: Prophylactic chemotherapy withfos-fomycin trometamol versus placebo during transurethral prostatic resection. Infection 1990; 18, Suppl. 2,103 -106
  4. 4. Borkowski A, Borówka A: Choroby gruczołu krokowego. Warszawa, Wydawnictwo Lekarskie PZWL, 1997; 165-173.
  5. 5. Borkowski A, Borówka A: Nowe metody leczenia kamicy górnych dróg moczowych. Warszawa, Wydawnictwo Lekarskie PZWL, 1994; 130-160.
  6. 6. Borkowski A, Borówka A: Nowe metody leczenia kamicy górnych dróg moczowych. Warszawa, Wydawnictwo Lekarskie PZWL, 1994; 182-193.
  7. 7. Richaud C. Single dose treatment of lower urinary tract infection in women: results of a trial with fosfomycin trometamol versus pefloxa-cin. Med Mai Infection 1995; 25; 154-159.
  8. 8. Greenwood D, Coyle S, Andrew J: The trometamol salt of fosfomycin: microbiological evaluation. Eur Urol 1987; 13, Suppl; 69-75.
  9. 9. Hooton TM: Tlie epidemiology of urinaty tract infection and the concept of significant bacteria. Infection 1990; 18, Suppl, 40-43.
  10. 10. Turbachova I, Eberl M, Zeidler J, Lichtenthaler HK, Soldati D, Beck E: Inhibitors of the nonmevalonale pathway of isoprenoid biosynthesis as antimalarial divgs [see comments]. Comment in: Science 1999; 285 (5433); 1502.
  11. 11. Pcarlc MS, Roehrbom CG: Antimicrobial prophylaxis prior to shock wave lithotripsy in patients with sterile urine before treatment: a meta-analysis and cost-effectiveness analysis. Urology 1997; 49; 679-86.
  12. 12. Childs SJ; Perioperative prevention of infection in genito-urinary surgery. Antibiot. Chemother 1985; 33; 1-29.
  13. 13. Chodak GW, Plaut ME: Systemic antibiotic prophylaxis in urologie surgery: critical review. J Urol 1979; 121; 695-699.
  14. 14. Gallego A, Rubin JM: Fosfomycin: Laboratpiy result. Chemotherapy 1977; 23 (Suppl.) 1-441.
  15. 15. Periti P, Novelli A, Reali EF, Del Bono GP, Fontana P: Prophylactic chemotherapy with fosfomycin trometamol salt in transurethral prostatectomy. A controlled clinical trial. Rozdział w książce „New trends in urinary tract infections\\\" pod red. Neu H. C, Williams J. D. Karger, Basel, 1998; 207-233.
  16. 16. Webster GK Bell RG: Gas chromatographic analysis of fosfomycin in plasma for phannacokinetic analysis. Journal of AOAC International 1999; 82 (3); 620-4.
  17. 17. Ikeda K Ida O, Kimoto K Takatorigc T, Nakanishi N, Tatara K: Effect of early fosfomycin treatment on prevention of hemolytic uremic syndrome accompanying Escherichia coli 0157: H7 infection. Clin Nephrol 1999; 52 (6); 357-362.
  18. 18. Kirby WMM: Pharmacokinetics of fosfomycin. Chemotherapy 1977; 23 Suppl; 141-151.
  19. 19. Bernat BA, Laughlin LT, Armstrong RN: Elucidation of a monovalent cation dependence and characterization of the divalent cation binding site of the fosfomycin resistance protein (FosA). Biochemistry 1999; 38 (23); 7462-7469.
  20. 20. Murakami H, Matsumaru H, Kanamori M, Ilayashi H, Ohta T: Cell wall-affecting antibiotics induce expression of a novel gene. dtp35, in Staphylococcus aureus. Biochemical & Biophysical Research Communications 1999; 348-51.
  21. 21. Neu HC: Fosfomycin trometamol versus amoxycilin- single dose multicenter study of urinary tract infections. Chemotherapy (Basel) 1990; 36 Suppl, 19-23.

correspondence

Tomasz Szopiński
Stara Miłosna, ul.Jana Pawła II 31 m. 18
05-077 Wesola
lei. 10-22) 77.) 3151. e-mail:uro@csk.waw.pl