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 .
Optimizing prophylactic antibiotic regimen in patients admitted for transrectal ultrasound-guided prostate biopsies: A prospective randomized study
Background Transrectal ultrasound-guided prostate biopsies ( TRUSBx ) , in spite of being one of the most frequently performed urological office procedures , are associated with a spectrum of complications , most significantly including infection . The aim of the study is to evaluate the prevalence of fluoroquinolone-resistant bacteria in rectal swabs from our local population prior to TRUSBx and to identify risk factors among a patient population harboring fluoroquinolone-resistant organisms . Methods We prospect ively included 541 men who were su bmi tted for TRUSBx in our center from March 2011 to June 2015 . The indications for TRUSBx were an elevated prostate-specific antigen level and /or abnormal digital rectal exam . All patients were r and omly divided into two groups : Group 1 ( n = 279 cases ) who received st and ard empirical prophylactic antibiotics and Group 2 who received targeted prophylaxis based on a rectal swab culture and susceptibility result . Differences in risk factors between quinolone-resistant and nonresistant patients were compared . Univariate and multivariate analyses were performed to identify independent potential risk factors associated with fluoroquinolone-resistant rectal flora . Results Sixteen out of 271 men developed infectious complications after TRUSBx in the group receiving st and ard empirical prophylaxis ( 5.7 % ) . No men in the group who received targeted prophylactic antibiotic guided by rectal swab developed infectious complications . Among the 262 patients who underwent prebiopsy rectal swab cultures , 76 men ( 29 % ) displayed fluoroquinolone-resistant rectal flora ( 29 % ) . In the multivariate analysis , a history of antibiotic exposure before prostate biopsy was the only independent factor associated with an increased risk of fluoroquinolone resistance . Conclusion Determining the prevalence of fluoroquinolone resistance in rectal flora has important implication s in the selection of targeted prophylactic antibiotic regimens . Antimicrobial profiles guided by rectal swabs may prove useful to optimize prophylaxis prior to TRUSBx ; this strategy is effective at reducing the rates of infectious complications , including sepsis , especially in men at higher risk of infectious complications
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 .