At introduction of new modes of antibacterial therapy of hospital infections, such as C. difficile, is necessary to consider possibility of increase of frequency of infectious complications after surgical interventions. These data are the main results of the research published in the BJUI magazine.
Researchers from Addenbruksky hospital, Cambridge, Great Britain, have found out that at patients whom carry out standard surgical interventions for diagnostics of a cancer of a prostate, in 5 times infectious complications at application of new modes of antibacterial therapy more often develop. Complications include sepsis and septic shock. «These changes reflect our fears that frequency of infection of C. Difficile increases in connection with frequent application of preparations of a wide range, for example, ципрофлоксацина», the author of the research David Neal speaks.
Authors have carried out the analysis of 709 consecutive patients which carried out a transrectal biopsy of a prostate during 20 months. Results show that only at 2,4 % from 454 patients which received standard antibacterial prevention tsiprofloksatsiny, infectious complications within 4 weeks after procedure in comparison with 12,9 % of the patients receiving new modes (амоксиклав and gentamycin) have developed. 4 and 12 patients, respectively have been thus hospitalised. Sepsis developed only at the patients receiving a new mode of prevention. Repeated return to a standard mode of prevention allowed to reduce frequency of infectious complications.
«Though the biopsy of a prostate is frequent urological intervention, now there are no national recommendations about antibacterial prevention, and in many areas of the country local protocols» operate, tells Neal. «However importance of application of prevention for decrease in frequency of infectious complications is well a fact in evidence. Our research is the first in which compared prevention амоксиклавом / gentamycin with tsiprofloksatsiny at patients before a biopsy».
Authors emphasise that antibacterial prevention should reflect both local data on the main strains, and indicators of resistance of microflora. «Any changes of protocols should be proved, as they can influence health of patients and health system expenses», Neal has come to a conclusion.