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 .
The impact of repeat biopsies on infectious complications in men with prostate cancer on active surveillance.
PURPOSE Prostate biopsy related infectious complications are associated with significant morbidity . The risk of infectious complications in patients with prostate cancer on active surveillance remains under studied . MATERIAL S AND METHODS A total of 591 consecutive men who underwent prostate biopsy were prospect ively enrolled in a study evaluating prostate biopsy related complications between January 2011 and January 2012 . Of these men 403 were previously diagnosed with prostate cancer and were included in this study . They underwent a 14-core transrectal ultrasound guided prostate biopsy as part of an active surveillance regimen . A nurse contacted all men within 14 days of biopsy , and information was collected on potential complications , antibiotics received and bacterial culture results . RESULTS Fourteen patients ( 3.5 % ) had infectious complications including 13 requiring hospitalization . Five patients had positive urine cultures , and fluoroquinolone resistant isolates were identified in 4 patients , including 2 with extended spectrum beta-lactamase producing isolates . We evaluated the impact of risk factors including diabetes , benign prostatic hyperplasia and antibiotic regimen . However , only the number of previous prostate biopsies was significantly associated with an increased risk of infectious complications ( p = 0.041 ) . For every previous biopsy the odds of an infection increased 1.3 times ( OR 1.33 , 95 % CI 1.01 - 1.74 ) . CONCLUSIONS In men with prostate cancer on active surveillance the number of previous prostate biopsies is associated with a significant risk of infectious complications and every previous biopsy increases the risk of infectious complication . Fluoroquinolone resistant and extended spectrum beta-lactamase producing isolates represent the most commonly identified organisms . Men with prostate cancer on active surveillance should be informed of the risks associated with serial repeat prostate biopsies
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 .