One preoperative dose randomized against 3-day antibiotic prophylaxis for transrectal ultrasonography-guided prostate biopsy.
OBJECTIVE
To compare the incidence of infective events between a single dose and 3-day antibiotic prophylaxis for transrectal ultrasonography (TRUS)-guided prostate biopsy.


METHODS
Patients were randomized to receive either one preoperative dose consisting of two ciprofloxacin 500 mg tablets 2 h before prostate biopsy, or 3 days of ciprofloxacin treatment. They had a clinical examination at study inclusion, the day of the biopsy and 3 weeks later. The day after the procedure all patients were contacted by telephone to inquire about any significant event. Biological testing and urine cultures were conducted 5 days before and then 5 and 15 days after the biopsy; a self-administered symptom questionnaire was completed by the patient 5 days before and then at 5 and 15 days.


RESULTS
The study group included 288 men, of whom 139 were randomized to the single-dose arm and 149 to the 3-day arm. Six patients in each group had an asymptomatic bacteriuria with no leukocyturia. One patient in each group had documented prostatitis, with Escherichia coli identified on urine culture. The strain identified in the patient from the 3-day group was resistant to ciprofloxacin. There was no difference between groups in symptoms at 5 and 21 days after biopsy.


CONCLUSIONS
Current TRUS-guided prostate biopsy techniques lead to very few clinical infectious complications when accompanied by antibiotic prophylaxis. We found no argument to advocate the use of more than one dose of antibiotic prophylaxis.
Briffaux
Raphaël
R
CHU La Milétrie, Poitiers, France.
Coloby
Patrick
P
Bruyere
Franck
F
Ouaki
Frédéric
F
Pires
Christophe
C
Doré
Bertrand
B
Irani
Jacques
J
D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000008:administration & dosage*; D019072:Antibiotic Prophylaxis / Q000379:methods*; D001437:Bacteriuria / Q000517:prevention & control*; D002939:Ciprofloxacin / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D004812:Epidemiologic Methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D011300:Preoperative Care / Q000379:methods; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods; D036761:Ultrasound, High-Intensity Focused, Transrectal / Q000379:methods*
D000890:Anti-Infective Agents; D002939:Ciprofloxacin