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 .
Bacterial sepsis following prostatic biopsy
Purpose Despite the recent innovations , complications of prostate biopsy can occur . The aim of this study was a prospect i ve monitoring of major septic complications occurring after transrectal prostate biopsy  , to describe their causing agents , to report the clinical course of these patients , and to give guidelines based on our personal experience . Methods This prospect i ve study was carried out between January 2009 and September 2010 . Complications were evaluated by telephone interviews . Results Between January 2009 and September 2010 , 447 ( 96.5 % ) completed the telephone interview .  Urosepsis occurred in ten patients ( 2.2 % ) and in three cases evolved into septic shock . Of these ten patients , nine had a positive blood culture , of whom eight for Escherichia coli and one for Aeromonas hydrophila , Aeromonas caviae , and Aeromonas sobria . In seven cases , the E. coli isolated were resistant to fluoroquinolone and six produced an extended spectrum beta-lactamase . Six E. coli were classified as multidrug-resistant organisms . Of the 10 patients , one died after the onset of multiorgan failure . For the other nine , the mean time spent in the hospital was 9 days ( range , 6–15 days ) . Conclusions Escherichia coli are developing new drug resistances . Early recognition of patients who harbor MDRO E. coli in their rectum or in the urine could be an important strategy for preventing sepsis . If a patient who has recently undergone transrectal prostate biopsy shows clinical signs of sepsis in the 48 h , a multiresistant E. coli infection must be suspected . The patient must be admitted urgently to the hospital , and carbapenem antibiotic therapy should be started
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 .