Antibiotic prophylaxis for transrectal needle biopsy of the prostate: a randomized controlled study

Aron, Monish; Rajeev, T P; Gupta, Narmada P.

doi:10.1046/j.1464-410x.2000.00576.x

Cited by 274 publications

(215 citation statements)

References 22 publications

(50 reference statements)

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“…These rates are similar to those reported in previous studies: 22-50% for hematuria and 1-22% for rectal bleeding. 6,7 We believe that the routine use of a urine bacterial culture before prostatic biopsy will increase the number of antibiotics prescribed, a factor directly related to the increased resistance rates of bacteria. 8,9 However, if a physician does elect to perform a urine bacterial culture and it is positive, the urologist may elect to perform the prostate biopsy with the patient taking antibiotics rather than delaying the procedure.…”

Section: Discussionmentioning

confidence: 99%

Is urine culture routinely necessary before prostate biopsy?

Bruyère

d’Arcier

Boutin

et al. 2010

Prostate Cancer Prostatic Dis

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The objective of this study was to assess the value of a urine bacterial culture performed before prostate biopsy. We performed a prospective study on 353 patients who underwent prostate biopsy. All patients had a urine bacterial culture performed before biopsy. We compared the outcomes of patients with bacteriuria (left untreated) with those of patients without bacteriuria. Of the 353 men, 12 had a pre-biopsy-positive bacterial culture and underwent prostate biopsy without any infectious complication. Fifteen patients with a negative pre-biopsy culture developed a postbiopsy-positive bacterial culture, but remained asymptomatic without any treatment. Only four men from the group without pre-biopsy bacteriuria developed an infectious complication, requiring 3 weeks of antibiotic therapy. The complication rates were similar for both groups. Our results suggest that routine urine bacterial culture before prostate biopsy is not useful when antibiotic prophylaxis and enema are performed. We do, however, suggest performing a urine bacterial culture before prostate biopsy for patients with a previous history of urinary tract infections.

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Section: Discussionmentioning

confidence: 99%

Is urine culture routinely necessary before prostate biopsy?

Bruyère

d’Arcier

Boutin

et al. 2010

Prostate Cancer Prostatic Dis

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“…[20] It has been demonstrated that single-dose ciprofloxacin prophylaxis obviated the need for hospitalization with the indication of febrile urinary infection, and decreases in infective complications, and hence treatment costs after prostate biopsy have been reported with ciprofloxacin prophylaxis. [21] In a prospective study, Aron et al [22] indicated lack of any significant difference between a single dose, and 3 daily oral doses of ciprofloxacin therapy. [22] In a study where infective complications were evaluated, the authors had achieved comparable outcomes with single dose 500 mg ciprofloxacin prophylaxis, twice daily doses of 500 mg ciprofloxacin, and a single dose parenteral ceftriaxone prophylaxis.…”

Section: Discussionmentioning

confidence: 99%

Comparison between ciprofloxacin and trimethoprim-sulfamethoxazole in antibiotic prophylaxis for transrectal prostate biopsy

Atılgan

Gençten

Kölükçü

et al. 2015

Turkish Journal of Urology

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Objective: The aim of this study was to compare the efficacies of oral ciprofloxacin administration and oral trimethoprim-sulfamethoxazole (TMP-SMX) regimens in preventing infectious complications following transrectal ultrasound guided biopsy of the prostate. Material and methods:Between 2011-2013, the medical records of 391 (mean age 64.62±7.64 years; range 40 to 87 years) patients who underwent transrectal prostate biopsies, due to suspicion of prostate cancer were retrospectively reviewed. While 500 mg ciprofloxacin was given orally twice daily starting one day before the procedure, continued for 3 days in the first 174 patients (group 1); was given orally twice daily starting one day before the procedure, continued for 3 days in the remaining 217 patients (group 2) for prophylaxis. Urine samples were obtained for urine culture before the procedure. The two groups were compared with respect to findings of urine cultures performed before and after the procedure and complications. Results:In the ciprofloxacin and groups, any positive urine culture before the procedure was not observed. Complications occured in 93 patients (37 in group 1 and 56 in group 2), after the procedure. Twenty-two (5.6%) (11 in group 1 and 11 in group 2). patients were admitted to our clinic because of high fever occurring after biopsy. Nine ciprofloxacin-treated (5.2%) and 16 TMP-SMX-treated (7.4%) patients had severe dysuria after the procedure. Twenty-one ciprofloxacin recipients (12.1%) and 40 TMP-SMX recipients (18.4%) had macroscopic hematuria. In the ciprofloxacin and TMP-SMX groups, the incidences of new culture positivity were 4% (n=7) and 2.8% (n=6) after the procedure, respectively. All of the isolated bacteria was Escherichia coli. While 11 patients were hospitalized due to signs of complicated urinary tract infections, and 2 patients were treated as outpatients. Rectal bleeding that did not require any intervention was observed in a patient 8 hours after biopsy. SIRS findings were detected in two patients. There were no significant differences between the two groups with respect to age, prostate volume, prostate spesific antigen (PSA) levels, and results of urine culture performed after the procedure (p>0.05). Conclusion:Despite the increasing resistance to antibiotics, ciprofloxacin and TMP-SMX are effective prophylactic treatment modalities for transrectal prostate biopsy. Both three-day ciprofloxacin and TMP-SMX regimens seem to be equally effective in the antibiotic prophylaxis for transrectal prostate biopsy.

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“…Both one-or three-day regimens using an oral fluoroquinolone 30 to 60 minutes before biopsy have been shown to be equivalent in relation to septic protection. [5][6][7][8][9] For each patient we verified that the antimicrobial prophylaxis was taken in accordance with the Canadian Urological Association guidelines and the American Urological Association Best Practice Policy Statement on Urologic Surgery. 10,11 Infection was defined as temperature above 38°C occurring within 48 hours after the procedure.…”

Section: Methodsmentioning

confidence: 99%

Effect of needle size on cancer detection, pain, bleeding and infection in TRUS-guided prostate biopsies: a prospective trial

McCormack

Duclos

Latour

et al. 2012

CUAJ

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Introduction: Transrectal ultrasound (TRUS)-guided prostate biopsies using 18G calibre needles are widely used; most often 12-core tissue samples of the peripheral zone are obtained. Although the diagnostic yield of prostate biopsies is fair, there is still a potential for false negative results, which necessitates repeat biopsies. In an effort to improve the accuracy of prostate biopsies, different sampling schemes have been developed. One strategy has been to increase the number of core biopsies performed on each patient. Another strategy has been to improve the reliability of prostate biopsies using larger calibre needles, thereby increasing the amount of tissue obtained for each core biopsy. Methods: After approval by our institutional review board, we prospectively compared two biopsy needle sizes (18G vs. 16G) in relation to prostate cancer diagnosis, pain, bleeding and infection rates on 105 patients. Each patient underwent 6 TRUS-guided prostate biopsies with the standard 18G needle and 6 other biopsies with the experimental 16G needle. To evaluate possible complications related to the use of a larger 16G needle in the experimental group, we compared pain, bleeding and infection rates with a control group of 100 patients who underwent 12 biopsies with a single 18G needle (18G group). Pain, bleeding assessment and infection events were evaluated using patient questionnaires and telephone interviews. Results: TRUS-guided prostate biopsies using 16G calibre needles did not increase cancer detection or non-malignant pathology rate, including prostatic intraepithelial neoplasia (PIN) and atypical small acinar proliferatio (ASAP). Pain, bleeding and infectious complications were similar in both groups. Infection was defined as temperature above 38°C occurring within 48 hours after the procedure. We identified 4 patients with post-biopsy fever in the experimental (16/18G) group and 4 other patients in the (18G) control group. The post-biopsy infection rate is higher than reported just a few years ago and indicates that quinolone resistant Escherichia coli seems to be more prevalent in our urban setting than previously suspected. Limitations to our study include small group numbers. Conclusion: Larger 16G needles appear to be safe for TRUS-guided prostate biopsies. Further study in a larger, multi-institutional, prospective, randomized manner with 16G needles is warranted to assess the theoretical benefit of larger core biopsies in prostate cancer detection.

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Antibiotic prophylaxis for transrectal needle biopsy of the prostate: a randomized controlled study

Cited by 274 publications

References 22 publications

Is urine culture routinely necessary before prostate biopsy?

Is urine culture routinely necessary before prostate biopsy?

Comparison between ciprofloxacin and trimethoprim-sulfamethoxazole in antibiotic prophylaxis for transrectal prostate biopsy

Effect of needle size on cancer detection, pain, bleeding and infection in TRUS-guided prostate biopsies: a prospective trial

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