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 .
Cephalosporins periprostatic injection: are really effective on infections following prostate biopsy?
Purpose To compare the antibiotic prophylaxis based on quinolone administered orally with a combination of cephalosporin administered periprostatically and a fluoroquinolone orally , in terms of post-prostate bioptic infectious complication rates in those men undergoing transrectal ultrasound-guided prostate biopsy ( TRUS gpb ) . Methods In a prospect i ve , r and omized , double-blind study , 150 consecutive patients were r and omized to receive 10 ml lidocaine 1 % in Group A and ceftriaxone 1 g diluted in a solution of 10 ml of lidocaine 1 % in Group B , before TRUS gpb . All signed the informed consent . The men were asked to grade the pain using a ten points visual analogue scale close after TRUS gpb . In a telephone interview at 3 and 6 days , they were asked about early and late complications , assessing rectal bleeding , urinary retection , fewer , haematuria , urethral bleeding and hematospermia . Results Of the 150 men enrolled , 135 , 70 in Groups A and 65 in Group B , completed the study . Four men ( 5.7 % ) in Group A developed sepsis after TRUS gpb requiring hospital admission and intravenous antibiotic treatment , while none in Group B. Escherichia coli was the only organism isolated . The mean pain score was 2.76 ± 1.69 and 1.73 ± 1.26 for Group A and B , respectively ( p = 0.08 ) . Complications , evaluated at 3 and 6 days after the procedure through a telephone interview , were similar in both Groups . Conclusions The antibiotic prophylaxis based on the combination of ceftriaxone administered periprostatically and ciprofloxacin orally is able to offer a best control on infections caused by fluoroquinolone-resistant E. coli
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 .