Widespread use of fluoroquinolone prophylaxis may be associated with an increase in resistant Escherichia coli strains , posing a potentially major health issue in the future .
INTRODUCTION Transrectal ultrasound-guided biopsies ( TRUS-gb ) are associated with both mild and serious complications .
Prophylactic antibiotics reduce the risk of septicaemia and mortality ; however , no international consensus exists on the timing and duration of antibiotics , including the optimal drug strategy .
We review ed the current evidence supporting use of prophylactic antibiotics and the risk of complications following prostate biopsies .
Single-dose antibiotic prophylaxis in core prostate biopsy: Impact of timing and identification of risk factors.
OBJECTIVES To assess the level of infectious complications and the impact of timing of a single , prophylactic , oral dose of ciprofloxacin 750 mg given either 2 hours before or in conjunction with ultrasound-guided core biopsy of the prostate in men without recognised risk factors and to analyse potential risk factors . METHODS All men undergoing prostate biopsy for elevated prostate specific antigen or clinical suspected prostate cancer were enrolled in an open , comparative prospect i ve study . Excluded were men with recognised risk factors for infective complications . Two end points were chosen : febrile genitourinary infection and the results of postbiopsy urine culture . RESULTS A total of 1322 prostate biopsy occasions were made in 1157 men . Twelve ( 0.9 % ) cases of febrile genitourinary infections were recorded , two of which had proven sepsis . Administrating the drug 2 hours before or at the time of biopsy ( p > 0.5 ) showed no statistical difference . Eight of 12 patients were shown to have prebiopsy undisclosed risk factors . Four percent developed postbiopsy , asymptomatic , significant bacteriuria . In addition , three ( 27 % ) men with prebiopsy unrecognised bacteriuria , who were accidentally enrolled , developed febrile genitourinary infection ; one had proven sepsis . CONCLUSIONS A single high-dose of oral ciprofloxacin 750 mg can be administered in direct conjunction with prostate biopsy to men without recognised risk factors , keeping the infection rate at approximately 1 % . Bacteriuria before biopsy is a major risk factor for infective complications . Attention given to recognising individual risk factors would reduce the risk of infection further
Widespread use of fluoroquinolone prophylaxis may be associated with an increase in resistant Escherichia coli strains , posing a potentially major health issue in the future .
INTRODUCTION Transrectal ultrasound-guided biopsies ( TRUS-gb ) are associated with both mild and serious complications .
Prophylactic antibiotics reduce the risk of septicaemia and mortality ; however , no international consensus exists on the timing and duration of antibiotics , including the optimal drug strategy .
We review ed the current evidence supporting use of prophylactic antibiotics and the risk of complications following prostate biopsies .