Sepsis rates after ultrasound-guided prostate biopsy using a bowel preparation protocol in a community hospital.
OBJECTIVE
The purpose of this study was to determine whether the addition of disposable enemas and a 24-hour diet of clear fluids to the bowel preparation protocol before transrectal ultrasound-guided prostate biopsy decreases the rate of postbiopsy sepsis.


METHODS
Sepsis rates of patients who underwent transrectal ultrasound-guided prostate biopsies at a community hospital were analyzed before and after a new bowel preparation protocol was introduced in our department. All patients received the antibiotic ciprofloxacin both before and after the biopsy. The first group (190 patients) had a preparation protocol that only asked the patients to stop eating by midnight (clear fluids only) on the day before the biopsy. The second group involved 217 patients and followed a bowel-cleansing biopsy preparation protocol. This protocol included the use of 2 disposable enemas and a diet of clear fluids for 24 hours preceding the biopsy. A systematic chart review was then performed to determine which patients had required treatment for postbiopsy sepsis.


RESULTS
Sepsis occurred in 4 patients (2.11%) in group 1 and 1 patient (0.46%) in group 2. After performing a 2-sided Fisher exact test, it was found that there was no significant difference between the groups at a 95% confidence level (P = .189).


CONCLUSIONS
The 24-hour clear-fluid diet and the use of disposable enemas combined with a regimen of ciprofloxacin decreased the rate of postbiopsy sepsis in patients who underwent transrectal ultrasound-guided prostate biopsy, but the results were not significantly different.
Department of Biology, Queens University, Kingston, Ontario, Canada.
Francesca
F
Ruddick
Paul
P
Sanders
Simon G
SG
Bicknell
Paul
P
Crofts
D000368:Aged; D000369:Aged, 80 and over; D019072:Antibiotic Prophylaxis; D001707:Biopsy, Needle / Q000009:adverse effects*; D004032:Diet; D004733:Enema; D006801:Humans; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D011467:Prostate / Q000000981:diagnostic imaging / Q000473:pathology*; D018805:Sepsis / Q000209:etiology / Q000517:prevention & control*; D018084:Ultrasonography, Interventional