Effectiveness of fosfomycin trometamol 3 g (Ovea®) in antibacterial prevention of infectious and inflammatory complications of bipolar prostate enucleation

Rationale. Experience of successful of fosfomycin trometamol 3 g use in lower urinary tract infections treatment and remaining sensitivity of most microorganisms to fosfomycin lead up to this trial conduction. An open prospective study comparing effectiveness of fosfomycin trometamol 3 g (Ovea®) use with standard antibacterial prevention of infectious and inflammatory complications of bipolar prostate enucleation. Materials and methods. Surgery was performed in 93 patients with benign prostatic hyperplasia in the period from June to September 2019 in D.D. Pletnev Municipal Clinical Hospital. The final analysis included 61 patients, the group was randomized into study group in which patients received Ovea® (fosfomycin trometamol 3 g) as antibacterial prevention before and after surgery and control group in which patients received intramuscular injections of ceftriaxone 1000 mg 2 times a day. Baseline clinical parameters including symptoms, results of urodynamic, ultrasound, and laboratory studies were similar in both study groups. In all patients transurethral bipolar prostate enucleation of benign prostatic hyperplasia was performed. Results. Functional results of treatment were similar in both groups. Hyperthermia more than 37.5°С was observed in (37%) in study group, and in 13 (42%) in control group. Antimicrobial drug was changed in 4 patients in study group and in 6 patients in control group. There were no cases of antimicrobial drug discontinuation associated with adverse events development. During the first month after surgery 3 patients in study group and in 4 patients in control group developed clinical symptoms of chronic prostatitis exacerbation and 1 patient in control group developed left sided epididymo-orchitis (С-DII). Diarrhea developed in 1 patient in control group an the 4th day, and in 3 patients in control group, rash - in 2 patients in control group, headache - in 1 patient, and 1 patient complained of upper abdomen discomfort after second fosfomycin intake. Six patients in control group developed injection site pain, and 3 patients gave up on antibacterial therapy after 4 days. Conclusion. Effectiveness and safety results of Ovea® use allow us to recommend its use as a medication for antibacterial prevention and treatment after transurethral anatomic prostate enucleation. Key words: benign prostatic hyperplasia, fosfomycin, antibacterial prevention. For citation: Martov A.G., Ergakov D.V. Effectiveness of fosfomycin trometamol 3 g (Ovea®) in antibacterial prevention of infectious and inflammatory complications of bipolar prostate enucleation. Consilium Medicum. 2020; 22 (6): 58-63. DOI: 10.26442/20751753.2020.6.200243

benign prostatic hyperplasia, fosfomycin, antibacterial prevention