Assessment of antimicrobial prophylaxis to prevent perioperative infection in patients undergoing prostate brachytherapy: Multicenter cohort study

Rikiya Taoka, Yoshikazu Togo, Tatsuhiko Kubo, Masahito Kido, Kenta Miki, Hiroshi Kiyota, Shin Egawa, Takashi Sugawara, Mitsuru Yasuda, Masahiro Nakano, Takashi Deguchi, Masashi Nishino, Kiyohito Ishikawa, Ryoichi Shiroki, Minori Matsumoto, Katsumi Shigemura, Kazushi Tanaka, Soichi Arakawa, Masato Fujisawa, Koichiro WadaToyohiko Watanabe, Hiromi Kumon, Kanao Kobayashi, Akio Matsubara, Takehiko Sho, Ryoichi Hamasuna, Tetsuro Matsumoto, Hiroshi Hayami, Masayuki Nakagawa, Shingo Yamamoto

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)


To propose an appropriate prophylactic antimicrobial therapy for patients undergoing brachytherapy, we evaluated the relationships between various antimicrobial prophylaxis (AMP) protocols and the incidence of postimplant infections in a multicenter cohort study conducted in Japan. The records of 826 patients with localized prostate cancer who underwent a transperineal 125I brachytherapy procedure between January 2009 and December 2010 were retrospectively reviewed. Perioperative infections, including surgical site and remote infections, were recorded up to postoperative day 30. A total of 6 (0.73 %) patients had a perioperative infection following seed implantation, of whom all received AMP for 1 or more days. None of the patients who received a single-dose protocol of AMP using fluoroquinolone p.o. or penicillin with a beta-lactamase inhibitor i.v. developed a perioperative infection. Statistical analysis showed that a single-dose protocol was more significantly related to a lower risk of perioperative infection as compared to the other AMP protocols examined (p = 0.045). Furthermore, our results indicated that bacteriuria and preoperative hair removal were risk factors of perioperative infection with statistical significance (p = 0.007, p = 0.004). Analysis of patient clinical parameters, including age, American Society of Anesthesiologists score, diabetes mellitus, prostate volume, numbers of implanted seeds and needle punctures, operation time, and indwelling duration time of the Foley catheter, did not reveal significant differences in terms of perioperative infection. Our results indicated that a single-dose AMP protocol is sufficient to prevent perioperative infections following seed implantation. On the other hand, AMP is only one of several measures to prevent perioperative infectious complications. It is necessary to know that the patient must have no bacteriuria and that preoperative hair removal should be avoided.

Original languageEnglish
Pages (from-to)926-930
Number of pages5
JournalJournal of Infection and Chemotherapy
Issue number5
Publication statusPublished - Oct 2013


  • Antimicrobial prophylaxis
  • Prostate brachytherapy

ASJC Scopus subject areas

  • Microbiology (medical)
  • Pharmacology (medical)
  • Infectious Diseases


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