Active substances: Amoxicillin
Identification of microorganisms was performed using approved conventional methods. This period has not been included in the evaluation of time trends of ciprofloxacin resistance.
In patients with both bacteraemia and UTI with an identical organism isolated, only bacteraemia was recorded.
Quantitative data are presented as numbers with percentages. A binary logistic regression analysis was used to examine the association between possible predictive factors for the occurrence of bacteraemia and UTI after prostate biopsy.
Analysis of variance was used to evaluate differences in the mean and median values between groups and the Bonferroni test was used as a post hoc test.
A relative risk of 1.
Results A total of 2823 TRUBP procedures performed in 2621 patients with a median age of 67 years range 32—98 years were included in the study.
There was no significant difference in the patients' ages and comorbidities between the groups.
When divided into three groups Group 1, Group 2 and Group 3, the median interval between biopsy and positive blood culture was 2. All patients with a positive blood culture had only one bacteraemic episode.
There are theoretical and experimental reasons for using a continuous infusion of penicillin.
The American Heart Association AHA advises ceftriaxone for the penicillin-allergic patient—but this should only be used for allergy other than immediate-type hypersensitivity because of the risk of cross-sensitivity with penicillin. If the diagnosis of endocarditis is in doubt, the patient is clinically stable and has already received antibiotics, we recommend stopping any antibiotics for 2—4 days and re-culturing.
Therapy should be reviewed as soon as the aetiological agent is identified.
There is evidence from patients with enterococcal endocarditis and some data from early studies of streptococcal endocarditis to suggest that patients who have had symptoms for more than 3 months benefit from 6 weeks of penicillin.
These factors should be taken into consideration when determining treatment length. Neutropenia is, however, a well described side effect of ceftriaxone, occurring in two of 55 patients in one study.
The choice of treatment for staphylococcal endocarditis will depend more on the antibiotic sensitivity of the isolate than whether it is coagulase positive or negative.
In the previous guidelines, therapy with benzyl penicillin was recommended for penicillin-sensitive strains. In practice, such strains are uncommon.
There is no evidence that the addition of gentamicin is more likely to result in a successful outcome, but it is associated with an increased incidence of adverse effects.
There is no evidence that the addition of sodium fusidate offers any advantage, 33 and the benefit of rifampicin is also controversial.
Owing to the reported incidence of treatment failure, we do not recommend the routine use of teicoplanin in the treatment of staphylococcal endocarditis. However, in patients with right-sided endocarditis often iv drug abusers, several trials have demonstrated the efficacy of short course iv combination therapy 32, 44 — 48 and oral therapy.
The use of these agents in the treatment of endocarditis has been described in the literature, but experience is still limited.
We would only recommend the use of such agents as salvage therapy, in patients unable to tolerate conventional therapy, or from whom particularly resistant stains have been recovered.
Similarly, the use of co-trimoxazole, quinolones and clindamycin has also been described in the literature, but we cannot advocate their routine use.
Streptococci are common causes of native valve and late prosthetic valve endocarditis. They vary in their susceptibility to penicillin and degree of resistance to aminoglycosides.