title: Single-dose antibiotic prophylaxis in core prostate biopsy: Impact of timing and identification of risk factors.
abstract: OBJECTIVE
  To assess the level of infectious complications and the impact of timing of a single, prophylactic, oral dose of ciprofloxacin 750 mg given either 2 hours before or in conjunction with ultrasound-guided core biopsy of the prostate in men without recognised risk factors and to analyse potential risk factors.
  
  
  METHODS
  All men undergoing prostate biopsy for elevated prostate specific antigen or clinical suspected prostate cancer were enrolled in an open, comparative prospective study. Excluded were men with recognised risk factors for infective complications. Two end points were chosen: febrile genitourinary infection and the results of postbiopsy urine culture.
  
  
  RESULTS
  A total of 1322 prostate biopsy occasions were made in 1157 men. Twelve (0.9%) cases of febrile genitourinary infections were recorded, two of which had proven sepsis. Administrating the drug 2 hours before or at the time of biopsy (p > 0.5) showed no statistical difference. Eight of 12 patients were shown to have prebiopsy undisclosed risk factors. Four percent developed postbiopsy, asymptomatic, significant bacteriuria. In addition, three (27%) men with prebiopsy unrecognised bacteriuria, who were accidentally enrolled, developed febrile genitourinary infection; one had proven sepsis.
  
  
  CONCLUSIONS
  A single high-dose of oral ciprofloxacin 750 mg can be administered in direct conjunction with prostate biopsy to men without recognised risk factors, keeping the infection rate at approximately 1%. Bacteriuria before biopsy is a major risk factor for infective complications. Attention given to recognising individual risk factors would reduce the risk of infection further.
authors.affiliation: Department of Urology, Malmö University Hospital, University of Lund, Malmö, Sweden.
authors.forename: Sandra
authors.initials: S
authors.lastname: Lindstedt
authors.forename: Ulla
authors.initials: U
authors.lastname: Lindström
authors.forename: Eva
authors.initials: E
authors.lastname: Ljunggren
authors.forename: Björn
authors.initials: B
authors.lastname: Wullt
authors.forename: Magnus
authors.initials: M
authors.lastname: Grabe
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000008:administration & dosage*; D019072:Antibiotic Prophylaxis; D001424:Bacterial Infections / Q000209:etiology* / Q000517:prevention & control*; D001707:Biopsy, Needle / Q000009:adverse effects; D002939:Ciprofloxacin / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011467:Prostate / Q000473:pathology*; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors
chemical_list: D000890:Anti-Infective Agents; D002939:Ciprofloxacin