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 .
Outcomes of fecal carriage of extended-spectrum β-lactamase after transrectal ultrasound-guided biopsy of the prostate.
OBJECTIVE To determine the prevalence of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae ( PE ) fecal carriage in patients that undergo transrectal ultrasonography-guided biopsy ( TRUSbx )  and its relationship with post-biopsy infections . METHODS A prospect i ve clinical study in 4 different tertiary hospitals between 2008 and 2010 was conducted . Four hundred men with sterile urine who were to undergo a TRUSbx because of the suspicion of prostate cancer were included and followed for 14 days after biopsy .  Rectal swab culture specimens were acquired immediately before the procedure . Demographic data , prophylaxis choice ,  quinolone or any  other antibiotic consumption within the past 2 months , history of prostatitis , repeat biopsy , intensive care unit admission , hospitalization , urethral catheterization , diabetes mellitus ( DM ) , and steroid usage were recorded . RESULTS ESBL carriage was detected in 19 % of patients and quinolone use within the last 2 months ; other antibiotic use within the last 2 months and DM were found to be significantly associated ( P < .05 ) . Symptomatic urinary tract infection ( UTI ) on the third day after biopsy was seen in 9 % of patients and was associated with fluoroquinolone ( FQ ) consumption before biopsy . Although ESBL-PE carriage was associated with post-biopsy UTI symptoms , it was not found to be associated with post-biopsy symptomatic UTI . Urosepsis was seen in 2 patients ( 0.5 % ) after biopsy , and both the patients were ESBL-PE carriers . CONCLUSION The presence of ESBL-PE was associated with DM and FQ consumption before biopsy . ESBL-PE carriage was associated with a high rate of post-biopsy UTI symptoms requiring further elucidation ; however , it was not associated with microbiologically proven infections . FQ consumption before TRUSbx was also associated with post-biopsy infections
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 .