Eficacia de fosfomicina vs ciprofloxacino en la profilaxis antibiótica de la biopsia transrectal de próstata en el Hospital Regional Docente de Trujillo
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Date
2022-12-05
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Universidad Nacional de Trujillo
Abstract
El cáncer de próstata es una patología frecuente y causa importante de mortalidad entre nuestra población, siendo la biopsia transrectal de próstata el procedimiento necesario para el diagnóstico, sin embargo, este procedimiento se encuentra asociado a complicaciones infecciosas por lo que las guías internacionales recomiendan el uso de profilaxis antibiótica previa al procedimiento. Las fluoroquinolonas, en especial el ciprofloxacino, han sido los antibióticos clásicamente usados para este fin, sin embargo, se ha notado una alta tasa de resistencia a dichos antibióticos en los últimos años; siendo necesario evaluar la efectividad de nuevas alternativas, surgiendo entre ellas la fosfomicina, un antibiótico con buenas concentraciones urinarias que ha demostrado en algunos estudios ser eficaz para la prevención de las complicaciones infecciosas asociadas a la biopsia transrectal de próstata. Objetivo: Evaluar la eficacia de la Fosfomicina en comparación con Ciprofloxacino en la profilaxis de la Biopsia Transrectal de Próstata. Materiales y métodos: Se realizará un estudio analítico, longitudinal, tipo cohorte prospectivo. Siendo la población los pacientes sometidos a biopsia transrectal de próstata en el Hospital Regional Docente de Trujillo entre el periodo julio 2022 a junio 2023, con una muestra de 80 pacientes en dos grupos, el primero formado por pacientes que recibieron como profilaxis antibiótica fosfomicina 3g VO en dosis única, y el segundo ciprofloxacino 500 mg VO cada 12 horas el día previo al procedimiento. Se evaluará hasta los 4 meses la aparición de complicaciones infecciosas (bacteriuria, infección del tracto urinario febril y sepsis). Resultados esperados: Se espera encontrar que la fosfomicina tiene mayor o igual eficacia que el ciprofloxacino en la profilaxis para la prevención de complicaciones infecciosas tras la realización de biopsia transrectal de próstata.
Prostate cancer is a frequent disease and an important cause of mortality among peruvian population, hence transrectal prostate biopsy is a necessary technique for diagnosis, however, this procedure is associated with infectious complications so international guides recommend the use of antibiotic prophylaxis prior to the procedure. Fluoroquinolones, especially ciprofloxacin, have been the traditional antibiotic used for this purpose, however, a high rate of resistance to these antibiotics has been noted in recent years; it is necessary to evaluate the effectiveness of new alternatives, among them fosfomycin, an antibiotic with good urinal concentrations that has shown in some studies to be effective for the prevention of infectious complications associated with transrectal prostate biopsy. Objective: To evaluate the effectiveness of fosfomycin compared to ciprofloxacin in the prophylaxis of transrectal prostate biopsy. Materials and methods: An analytical, longitudinal, prospective cohort study will be carried out. Population is the patients undergoing transrectal prostate biopsy at the Hospital Regional Docente de Trujillo between July 2022 and June 2023, with a sample of 80 patients in two groups, the first consisting of patients who received fosfomycin 3g VO in a single dose as prophylaxis antibiotic, and the second ciprofloxacin 500 mg VO every 12 hours the day before the procedure. The development of infectious complications (bacteriuria, febrile urinary tract infection and sepsis) will be evaluated up to 4 months. Expected results: Fosfomycin is expected to be more or as effective as ciprofloxacin in prophylaxis for the prevention of infective complications following transrectal prostate biopsy.
Prostate cancer is a frequent disease and an important cause of mortality among peruvian population, hence transrectal prostate biopsy is a necessary technique for diagnosis, however, this procedure is associated with infectious complications so international guides recommend the use of antibiotic prophylaxis prior to the procedure. Fluoroquinolones, especially ciprofloxacin, have been the traditional antibiotic used for this purpose, however, a high rate of resistance to these antibiotics has been noted in recent years; it is necessary to evaluate the effectiveness of new alternatives, among them fosfomycin, an antibiotic with good urinal concentrations that has shown in some studies to be effective for the prevention of infectious complications associated with transrectal prostate biopsy. Objective: To evaluate the effectiveness of fosfomycin compared to ciprofloxacin in the prophylaxis of transrectal prostate biopsy. Materials and methods: An analytical, longitudinal, prospective cohort study will be carried out. Population is the patients undergoing transrectal prostate biopsy at the Hospital Regional Docente de Trujillo between July 2022 and June 2023, with a sample of 80 patients in two groups, the first consisting of patients who received fosfomycin 3g VO in a single dose as prophylaxis antibiotic, and the second ciprofloxacin 500 mg VO every 12 hours the day before the procedure. The development of infectious complications (bacteriuria, febrile urinary tract infection and sepsis) will be evaluated up to 4 months. Expected results: Fosfomycin is expected to be more or as effective as ciprofloxacin in prophylaxis for the prevention of infective complications following transrectal prostate biopsy.
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Keywords
Ciprofloxacino, Fosfomicina, Biopsia, Profilaxis, Antibiótica, Próstata