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 .
Infective complications after prostate biopsy: outcome of the Global Prevalence Study of Infections in Urology (GPIU) 2010 and 2011, a prospective multinational multicentre prostate biopsy study.
BACKGROUND Infection is a serious adverse effect of  prostate biopsy ( P-Bx ) , and recent reports suggest an increasing incidence . OBJECTIVE The aim of this multinational multicentre study was to evaluate prospect ively the incidence of infective complications after P-Bx and identify risk factors . DESIGN , SETTING , AND PARTICIPANTS The study was performed as an adjunct to the Global Prevalence Study of Infections in Urology ( GPIU ) during 2010 and 2011 . Men undergoing P-Bx in participating centres during the 2-wk period commencing on the GPIU study census day were eligible . OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Baseline data were collected and men were question ed regarding infective complications at 2 wk following their biopsy . The Fisher exact test , Student t test , Mann-Whitney U test , and multivariate regression analysis were used for data analysis . RESULTS AND LIMITATIONS A total of 702 men from 84 GPIU participating centres worldwide were included . Antibiotic prophylaxis was administered prior to biopsy in 98.2 % of men predominantly using a fluoroquinolone ( 92.5 % ) . Outcome data were available for 521 men ( 74 % ) . Symptomatic urinary tract infection ( UTI ) was seen in 27 men ( 5.2 % ) , which was febrile in 18 ( 3.5 % ) and required hospitalisation in 16 ( 3.1 % ) . Multivariate analysis did not identify any patient subgroups at a significantly higher risk of infection after P-Bx . Causative organisms were isolated in 10 cases ( 37 % ) with 6 resistant to fluoroquinolones . The small sample size per participating site and in compared with other studies may have limited the conclusions from our study . CONCLUSIONS Infective complications after transrectal P-Bx are important because of the associated patient morbidity . Despite antibiotic prophylaxis , 5 % of men will experience an infective complication , but none of the possible factors we examined appeared to increase this risk . Our study confirms a high incidence of fluoroquinolone resistance in causative bacteria
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 .