Antimicrobial prophylaxis for transurethral resection of bladder tumor: A retrospective comparison of preoperative single-dose administration of piperacillin and tazobactam/piperacillin

• Published in: Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 2018-12, Vol.24 (12), p.954-957
• Main Authors: Murakami, Masaya, Kiyota, Hiroshi, Kasai, Kanako, Bando, Shigehiro, Kira, Shinichiro, Koide, Haruhisa, Yamada, Hiroki, Kimura, Takahiro, Egawa, Shin
• Format: Article
• Language: English
• Subjects: Administration, Intravenous; Aged; Anti-Bacterial Agents - administration & dosage; Anti-Bacterial Agents - therapeutic use; Antibiotic Prophylaxis - methods; Antimicrobial prophylaxis; Bacteriuria - blood; Bacteriuria - microbiology; Bacteriuria - urine; Bladder cancer; Female; Fever - blood; Fever - microbiology; Fever - urine; Humans; Male; Piperacillin; Piperacillin - administration & dosage; Piperacillin - therapeutic use; Piperacillin, Tazobactam Drug Combination - administration & dosage; Piperacillin, Tazobactam Drug Combination - therapeutic use; Preoperative Period; Retrospective Studies; Tazobactam - administration & dosage; Tazobactam - therapeutic use; Transurethral resection; Urinary Bladder Neoplasms - drug therapy; Urinary Bladder Neoplasms - surgery
• ISSN: 1341-321X; 1437-7780
• DOI: 10.1016/j.jiac.2018.08.008

We aimed to clarify prophylactic antimicrobial effects of single-dose piperacillin (PIPC) for perioperative infections in the transurethral resection of bladder tumor (TURBT) in comparison with those of single-dose tazobactam/piperacillin (TAZ/PIPC) through a retrospective analysis. We analyzed data from 192 TURBT patients treated with single-dose (4 g) intravenous PIPC (P group) between April 2015 and April 2017. For comparison, we analyzed data from 50 TURBT patients treated with single-dose (4.5 g) intravenous TAZ/PIPC (T/P group) between June 2013 and April 2014. We compared the perioperative incidences of fever (≥38 °C) and bacteriuria in the two groups. The number of febrile patients was four (2.1%) in the P group and one (2.0%) in the T/P group, without significant difference (p = 0.970). Among these febrile patients, urine and blood samples of two patients in the P group tested positive for bacterial cultures of Citrobacter koseri and Enterococcus faecalis, respectively. None of the patients in the T/P group tested positive for urine culture, postoperatively. However, 22 patients (18.2%) in the P group tested positive for urine culture, and Staphylococcus epidermidis (six patients), E. faecalis (three patients), Escherichia coli (three patients), Streptococcus agalactiae (two patients), Staphylococcus aureus (two patients), and C. koseri (one patient) were isolated. There was no significant difference in the incidence of bacteriuria in these two groups (p = 0.055). Based on these results, single-dose PIPC administration for the prevention of perioperative infections in TURBT was as effective as TAZ/PIPC.