MP13-14 ANTIBIOPROPHYLAXIS FOR TRANSRECTAL ULTRASOUND-GUIDED PROSTATE NEEDLE BIOPSY: IS PREVENTION OF POST-PROCEDURAL URINARY SEPSIS IMPROVED WITH THE NOVEL COMBINATION OF CIPROFLOXACIN AND FOSFOMYCIN?
Notice bibliographique
Résumé
You have accessJournal of UrologyProstate Cancer: Detection & Screening I (MP13)1 Apr 2019MP13-14 ANTIBIOPROPHYLAXIS FOR TRANSRECTAL ULTRASOUND-GUIDED PROSTATE NEEDLE BIOPSY: IS PREVENTION OF POST-PROCEDURAL URINARY SEPSIS IMPROVED WITH THE NOVEL COMBINATION OF CIPROFLOXACIN AND FOSFOMYCIN? Alexandre Morin*, Marco Bergevin, and Steven P Lapointe Alexandre Morin*Alexandre Morin* More articles by this author , Marco BergevinMarco Bergevin More articles by this author , and Steven P LapointeSteven P Lapointe More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000555227.90990.5aAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: Fluoroquinolones are recommended as first line antibioprophylaxis (ATBPx) for transrectal ultrasound-guided prostate needle biopsy (PNB). Recent studies report rising rates of post-PNB infections associated with emergent fluoroquinolone resistant E. coli, urging re-evalutation of ATBPx. The objective of this study was to compare rates of post-PNB sepsis associated with 2 oral regimens of ATBPx: a single dose of ciprofloxacin 500 mg (CIP) vs single dose of ciprofloxacin 500 mg and fosfomycin 3 g combination (CIP/FOS). METHODS: We performed a retrospective, pre-post intervention study on all patients who underwent PNB in 2 Canadian hospitals from January 2012 to December 2015. ATBPx was changed from CIP to CIP/FOS in December 2013. ATBPx was administered two hours prior to PNB, along with a sodium phosphate enema. Patient charts were reviewed for hospital visits, microbiologic results, and 14 recognized risk factors for post-PNB infectious complications. The primary outcome was urosepsis within 1 month of PNB. Sepsis rates, according to ATBPx regimens, were analyzed using log-binomial regression considering the propensity scores weights of collected risk factor data. RESULTS: We reviewed charts of 2,287 patients, including 1090 who received CIP alone and 1197 who received CIP/FOS. Urosepsis incidence with CIP alone was 1.1% (12/1090) and fell to 0.2% (2/1197) with CIP/FOS. Our analysis indicates that CIP/FOS significantly decreased the risk of sepsis compared to CIP alone (aRR = 0.16; p = 0.021). The pathogen was E. coli in 12/14 cases, with 7 CIP resistant strains. Most E. coli (11/12) were from CIP alone group. We observed 7 cases of E. coli bacteremia, with 5/7 blood cultures showing CIP resistant strains. One case of B. fragilis septicemia occurred in the CIP/FOS group. No cases of C. difficile diarrhea were identified within the 3 months post-PNB. CONCLUSIONS: The use of CIP/FOS prophylaxis in PNB significantly lowered our rates of post-procedural sepsis. Conveniently, this regimen is oral and obviates the need for rectal swab screening. Further prospective studies should be performed before widespread use of this antibioprophylaxis regimen. Source of Funding: AbbVie unrestricted educational grant Sherbrooke, Canada; Nathalie Rivest, Laval, Canada; Mont-Royal, Canada© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e182-e183 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Alexandre Morin* More articles by this author Marco Bergevin More articles by this author Steven P Lapointe More articles by this author Expand All Advertisement PDF downloadLoading ...
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,006 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,014 | 0,002 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».