Infections/Inflammation/Cystic Disease of the Genitourinary Tract: Prostate & Genitalia IMP15-06 DESPERATE NEED FOR OPTIMIZED MANAGEMENT IN FOURNIER’S GANGRENE
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INTRODUCTION AND OBJECTIVES
Fournier’s gangrene is a rare but very severe disease in urology. Unfortunately, there is a lack of data concerning this disease. Against the background of rising antibiotic resistance rates, we performed a multicentre retrospective study comparing an earlier versus a later patient group. Primary endpoints were the comparison in terms of therapy, outcome and resistance rates. Secondary endpoints were the identification of risk factors for death and multi-resistant pathogens.
METHODS
We performed a multicentre retrospective study in ten centres. Four of these centres were German University Medical Centres, four German hospitals of tertiary care and two hospitals of tertiary care in Austria. Two groups with different time frames of treatment were defined: Group 1 treated between January 2006 and December 2010 and Group 2 between January 2011 and December 2016. All patients treated in these time frame were included and analysed. Statistical analysis was performed using SPSS
RESULTS
On the whole, 154 patients were identified and evaluated in the ten centres: 50 patients belonged to Group 1 and 104 to Group 2. All patients were male. There was no significant difference between the groups concerning demographic characteristics like age. Additionally, there is no significant difference for therapy and outcome in the groups, except from duration of intensive care unit treatment, which was 6.3 days in mean in Group 1 and 11.5 days in Group 2 (p=0.018; T test). Even the survival
CONCLUSIONS
Despite the fact of increasing antibiotic resistance rates worldwide, we could not detect this phenomenon in one of the biggest study populations of Fournier’s gangrene in Europe. But the situation is alarming since outcome did not improve over the last ten years even with a more intensive treatment in critical care medicine. Additionally, the outcome of the disease is difficult to predict. Further multicentre studies are absolutely necessary to optimize the management of this disease.
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