Evaluation of perioperative prophylaxis with fosfomycin tromethamine in ureteroscopic stone removal: an investigator-driven prospective, multicenter, randomized, controlled study.

PURPOSE: To compare efficacy, safety, and cost-effectiveness of fosfomycin tromethamine with other standard-of-care antibiotics in patients undergoing ureteroscopic lithotripsy. METHODS: This study was a prospective, multicenter, randomized, controlled trial. Eligible patients scheduled for ureteroscopic lithotripsy were randomly assigned to receive either fosfomycin (fosfomycin group, N = 101 patients) or standard-of-care antibiotic therapy as prophylaxis (control group, N = 115 patients). The incidence of infectious complications and adverse events was analyzed between the two groups, as well as the cost-benefit analysis. RESULTS: The incidence of infections following lithotripsy was 3.0% in the fosfomycin group and 6.1% in the control group (p > 0.05). Only asymptomatic bacteriuria was reported in fosfomycin group. In the control group was reported asymptomatic bacteriuria (3.5%), fever (0.9%), bacteremia (0.9%), and genitourinary infection (0.9%). The rate of adverse events was very low, with no adverse event reported in the fosfomycin group and only one in the control group (forearm phlebitis). The average cost per patient of antibiotic therapy with fosfomycin was 151.45 ± 8.62 yuan (22.7 ± 1.3 USD), significantly lower compared to the average cost per patient of antibiotics used in the control group 305.10 ± 245.95 yuan (45.7 ± 36.9 USD; p < 0.001). CONCLUSIONS: Two oral doses of 3 g fosfomycin tromethamine showed good efficacy and safety and low cost in perioperative prophylaxis of infections following ureteroscopic stone removal.

[Eco-environmental quality assessment of Luoyuan Bay, Fujian province of East China based on biotic indices].

In this paper, two types of eco-environmental quality assessment indices that have been successively applied abroad, i.e., the AZTI marine biotic index (AMBI) and BENTIX index based on the ecological sensitivity of benthos and the multivariate-AMBI (M-AMBI), a multivariate index integrating AMBI, Shannon Index H', and species richness, were applied to assess the eco-environmental quality of Luoyuan Bay, Fujian Province of East China, and the assessment results were compared with those by the H', an index based on community structure, which is often applied in China, aimed to test the applicability of these indices to the Bay, and to provide reference in selecting the indices for assessing our coastal eco-environment quality. Similar assessment results were obtained by applying AMBI and BENTIX index, and M-AMBI and H'. At most stations (13 of 16), the assessment results by applying AMBI and BENTIX index, M-AMBI and H' were coincident, respectively; while at the other 3 stations, the assessment grade was high or good based on AMBI and BENTIX index, but moderate based on M-AMBI and H'. Taking account of the richness, individual abundance, and ecological group composition of the benthos in Luoyuan Bay, the assessment results based on M-AMBI and H' could be more reasonable. It was suggested that for the Luoyuan Bay which has a high level of eutrophication and low organic matter enrichment in sediment and is dominated by sensitive benthos species, M-AMBI and H' could be more applicative and objective than AMBI and BENTIX index in assessing its eco-environmental quality.