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 .
Complications after prostate biopsy: data from SEER-Medicare.
PURPOSE More than 1 million prostate biopsies are performed annually among Medicare beneficiaries . We determined the risk of serious complications requiring hospitalization . We hypothesized that with emerging multidrug resistant organisms there may be an increasing risk of infectious complications . MATERIAL S AND METHODS In a 5 % r and om sample of Medicare participants in SEER ( Surveillance , Epidemiology and End Results ) regions from 1991 to 2007 we compared 30-day hospitalization rates and ICD-9 primary diagnosis codes for admissions between 17,472 men who underwent prostate biopsy and a r and om sample of 134,977 controls . Multivariate logistic and Poisson regression were used to examine the risk and predictors of serious infectious and noninfectious complications with time . RESULTS The 30-day hospitalization rate was 6.9 % within 30 days of prostate biopsy , which was substantially higher than the 2.7 % in the control population . After adjusting for age , race , SEER region , year and comorbidities prostate biopsy was associated with a 2.65-fold ( 95 % CI 2.47 - 2.84 ) increased risk of hospitalization within 30 days compared to the control population ( p < 0.0001 ) . The risk of infectious complications requiring hospitalization after biopsy was significantly greater in more recent years ( p(trend ) = 0.001 ) . Among men undergoing biopsy , later year , nonwhite race and higher comorbidity scores were significantly associated with an increased risk of infectious complications . CONCLUSIONS The risk of hospitalization within 30 days of prostate biopsy was significantly higher than in a control population . Infectious complications after prostate biopsy have increased in recent years while the rate of serious noninfectious complications is relatively stable . Careful patient selection for prostate biopsy is essential to minimize the potential harms
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 .