, Volume 18, Supplement 2, pp S103–S106 | Cite as

Prophylactic chemotherapy with fosfomycin trometamol versus placebo during transurethral prostatic resection

  • L. Baert
  • I. Billiet
  • J. Vandepitte
Comparative Trials in Special Population Patients


A prospective randomized controlled double-blind study was performed on 61 patients undergoing transurethral resection of the prostate. The first group of 31 patients received 3 g fosfomycin trometamol p. o. each on the evening before and after the operation; the second group of 30 patients received a placebo. Urine samples were taken by catheter puncture 24 and 48 h postoperative. After removal of the catheter (day 5) the first midstream urine was collected for culture, and from that moment on all patients were treated with a nitrofurantoin derivative for two weeks. Although the same strict antiseptic measures were standard practice for both groups, the incidence of early postoperative urinary tract infections was significantly lower for the fosfomycin trometamol group (0/31 versus 6/30 in placebo recipients). None of the patients suffered from a major symptomatic or complicated infection. There were no side effects registered.


Placebo Placebo Recipient Transurethral Resection Nitrofurantoin Fosfomycin 
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Chemoprophylaxe mit Fosfomycin Trometamol im Vergleich zu Plazebo während transurethraler prostataresektion


Bei 61 Patienten, die sich einer transurethralen Prostataresektion unterziehen mußten, wurde eine prospektive randomisierte Doppelblindstudie durchgeführt. 31 Patienten erhielten am Abend vor und nach der Operation je 3 g Fosfomycin Trometamol per os, 30 Patienten erhielten Plazebo. 24 und 48 h nach der Operation wurden durch Katheterpunktion Urinproben entnommen. Nachdem der Katheter gezogen war (fünfter Tag), wurde der erste Mittelstrahlurin für die Kultur gewonnen und bei allen Patienten eine zweiwöchige Behandlung mit einem Nitrofurantoinderivat eingeleitet. Beide Gruppen wurden unter identischen aseptischen Standardbedingungen operiert; dennoch traten in der Gruppe, die Fosfomycin Trometamol erhalten hatte, signifikant weniger frühe postoperative Harnwegsinfektionen auf (0/31 im Vergleich zu 6/31 unter Plazebo). Zu schweren symptomatischen oder komplizierten Infektionen kam es bei keinem Patienten. Für Nebenwirkungen ergaben sich keine Hinweise.


  1. 1.
    Larsen, E. H., Gasser, T. C., Madson, P. O. Antimicrobial prophylaxis in urologic surgery. Urologic Clinics of N. A. 13 (1986) 591–604.Google Scholar
  2. 2.
    Childs, S. J. Perioperative prevention of infection in genito-urinary surgery. Antibiot. Chemother. 33 (1985) 1–29.Google Scholar
  3. 3.
    Morris, M. J., Golovsky, D., Guinness, M. D. G., Mahez, P. O. The value of prophylactic antibiotics in transurethral prostatic resection: a controlled trial with observations on the origin of the postoperative infection. Br. J. Urol. 48 (1976) 478–482.Google Scholar
  4. 4.
    Hirschmann, J. V., Inui, T. S. Antimicrobial prophylaxis: a critique of recent trials. Rev. Infect. Dis. 2 (1980) 13–14.Google Scholar
  5. 5.
    Ferrari, V., Bonanomi, L., Borgia, M., Lodola, E., Marca, G. A new fosfomycin derivate with much improved bioavailability by oral route. Chemioter. Antimicrob. 4 (1981) 59–63.Google Scholar
  6. 6.
    Gallego, A., Rubio, J. M. Fosfomycin: Laboratory result. Chemotherapy 23 (Suppl.) (1977) 1–441.Google Scholar
  7. 7.
    Kahan, F. M., Kahan, J. S., Cassidy, P. J., Kropp, H. The mechanism of action of fosfomycin. Annals New York Academy of Science 235 (1974) 364–386.Google Scholar
  8. 8.
    Greenwood, D., Coyle, S., Andrew, J. The trometamol salt of fosfomycin: microbiological evaluation. Eur. Urol. 13 (Suppl. 1) (1987) 69–75.Google Scholar
  9. 9.
    Segre, G., Bianchi, E., Cataldi, A., Zannini, G. Pharmacokinetic profile of fosfomycin trometamol (Monuril). Eur. Urol. 13 (Suppl. 1) (1987) 56–63.Google Scholar
  10. 10.
    Bergogne-Bérézin, E., Muller-Serieys, C., Joly-Guillon, M. L., Dronne, N. Trometamol fosfomycin (Monuril) bioavailability and food drug interaction. Eur. Urol. 13 (Suppl. 1) (1987) 64–68.Google Scholar
  11. 11.
    Gonzalez, R., Wright, R., Blackard, C. E. Prophylactic antibiotics in transurethral prostatectomy. J. Urol. 116 (1976) 203–205.Google Scholar
  12. 12.
    Gibbons, R. P., Stark, R. A., Correa, R. J. Jr., Cummings, K. B., Mason, J. The prophylactic use — or misuse — of antibiotics in transurethral prostatectomy. J. Urol. 119 (1978) 381–383.Google Scholar
  13. 13.
    Nielsen, O. S., Maigaard, S., Frimodt-Moller, N., Madsen, P. O. Prophylactic antibiotics in transurethral prostatectomy. J. Urol. 126 (1981) 60–62.Google Scholar
  14. 14.
    Matthew, A. D., Gonzalez, R., Jeffords, D., Pinto, M. H. Prevention of bacteriuria after transurethral prostatectomy with nitrofurantoin macrocrystals. J. Urol. 120 (1978) 442–443.Google Scholar
  15. 15.
    Hargreave, T. B., Hindmarsch, J. R., Elton, R., Chisholm, G. D., Gould, J. C. Short-term prophylaxis with cefotaxime for prostatic surgery. Br. Med. J. 284 (1982) 1008–1010.Google Scholar
  16. 16.
    Ramsey, E. W., Sheth, N. K. Antibiotic prophylaxis in patients undergoing prostatectomy. Urology 21 (1983) 376–378.Google Scholar
  17. 17.
    Millar, M. R., Inglis, T., Ewing, R., Clark, P., Williams, R. E., Lacey, R. W. Double blind study comparing aztreonam with placebo for prophylaxis of infection following prostatic surgery. Br. J. Urol. 60 (1987) 345–348.Google Scholar
  18. 18.
    Chodak, G. W., Plaut, M. E. Systemic antibiotic for prophylaxis in urologic surgery: a critical review. J. Urol. 121 (1979) 695–699.Google Scholar
  19. 19.
    Sullivan, N. M., Sutter, V. L., Mims, M. M., Marsh, V. H., Finegold, S. M. Clinical aspects of bacteremia after manipulation of the genito-urinary tract. J. Infect. Dis. 127 (1973) 49–54.Google Scholar
  20. 20.
    Cafferkey, N. T., Falkiner, F. R., Gillespie, W. A., Murphy, D. M. Antibiotics for the prevention of septicemia in urology. J. Antimicrob. Chemother. 9 (1982) 471–477.Google Scholar
  21. 21.
    Periti, P., Novelli, A., Reali, E. F., Lamanna, S., Fontana, P. Prophylactic chemotherapy with fosfomycin trometamol salt during transurethral prostatic surgery. Eur. Urol. 13 (1987) 122–131.Google Scholar
  22. 22.
    Periti, P., Novelli, A., Reali, E. F., Del Bono, G. P., Fontana, P. Prophylactic chemotherapy with fosfomycin trometamol salt in transurethral prostatectomy: A multicenter clinical trial. In:Neu, H. C., Williams, J. D. New trends in urinary tract infections. Karger, Basel 1988, pp. 207–223.Google Scholar

Copyright information

© MMV Medizin Verlag GmbH 1990

Authors and Affiliations

  • L. Baert
    • 1
  • I. Billiet
    • 1
  • J. Vandepitte
    • 2
  1. 1.Department of UrologyUniversity Hospital, Catholic UniversityLeuvenBelgium
  2. 2.Head of Microbiology DepartmentUniversity Hospital, Catholic UniversityLeuvenBelgium

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