title: A randomized comparative study of the prophylactic use of trimethoprim-sulfamethoxazole versus netilmycin-metronidazole in transrectal prostatic biopsy.
abstract: An open randomized study was done to compare the prophylactic value of single doses of netilmycin-metronidazole versus trimethoprim-sulfamethoxazole in the prevention of postoperative infections associated with transrectal prostatic biopsy. Of 117 patients enrolled in the study 101 were evaluated and of these patients 47 received netilmycin-metronidazole and 54 received trimethoprim-sulfamethoxazole. The bacteremia rate in the netilmycin-metronidazole group was 28% (13 of 47 patients) with a 95% confidence interval of 18 to 42% and in the trimethoprim-sulfamethoxazole group it was 37% (20 of 54) with a confidence interval of 26 to 50% (p = 0.43). None of the patients with bacteremia was symptomatic. Urinary tract infection rates were greater in the netilmycin-metronidazole group: 17% (8 of 47 patients) versus 2% (1 of 54) in the trimethoprim-sulfamethoxazole group, p = 0.01. Trimethoprim-sulfamethoxazole (cotrimoxazole) is a better choice as an antimicrobial prophylaxis for patients undergoing transrectal prostatic biopsy.
authors.affiliation: Department of Medicine, St. Michael's Hospital, University of Toronto, Ontario, Canada.
authors.forename: I W
authors.initials: IW
authors.lastname: Fong
authors.forename: N
authors.initials: N
authors.lastname: Struthers
authors.forename: R J
authors.initials: RJ
authors.lastname: Honey
authors.forename: M
authors.initials: M
authors.lastname: Simbul
authors.forename: D A
authors.initials: DA
authors.lastname: Boisseau
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000009:adverse effects*; D004338:Drug Combinations; D006801:Humans; D017053:Infection Control; D007239:Infections / Q000209:etiology; D008297:Male; D008795:Metronidazole / Q000008:administration & dosage* / Q000627:therapeutic use; D008875:Middle Aged; D009428:Netilmicin / Q000008:administration & dosage* / Q000627:therapeutic use; D011292:Premedication; D011467:Prostate / Q000473:pathology*; D018805:Sepsis / Q000517:prevention & control; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use*; D014552:Urinary Tract Infections / Q000517:prevention & control
chemical_list: D004338:Drug Combinations; D008795:Metronidazole; D009428:Netilmicin; D015662:Trimethoprim, Sulfamethoxazole Drug Combination