title: Cephalosporins periprostatic injection: are really effective on infections following prostate biopsy?
abstract: OBJECTIVE
  To compare the antibiotic prophylaxis based on quinolone administered orally with a combination of cephalosporin administered periprostatically and a fluoroquinolone orally, in terms of post-prostate bioptic infectious complication rates in those men undergoing transrectal ultrasound-guided prostate biopsy (TRUS gpb).
  
  
  METHODS
  In a prospective, randomized, double-blind study, 150 consecutive patients were randomized to receive 10 ml lidocaine 1 % in Group A and ceftriaxone 1 g diluted in a solution of 10 ml of lidocaine 1 % in Group B, before TRUS gpb. All signed the informed consent. The men were asked to grade the pain using a ten points visual analogue scale close after TRUS gpb. In a telephone interview at 3 and 6 days, they were asked about early and late complications, assessing rectal bleeding, urinary retection, fewer, haematuria, urethral bleeding and hematospermia.
  
  
  RESULTS
  Of the 150 men enrolled, 135, 70 in Groups A and 65 in Group B, completed the study. Four men (5.7 %) in Group A developed sepsis after TRUS gpb requiring hospital admission and intravenous antibiotic treatment, while none in Group B. Escherichia coli was the only organism isolated. The mean pain score was 2.76 ± 1.69 and 1.73 ± 1.26 for Group A and B, respectively (p = 0.08). Complications, evaluated at 3 and 6 days after the procedure through a telephone interview, were similar in both Groups.
  
  
  CONCLUSIONS
  The antibiotic prophylaxis based on the combination of ceftriaxone administered periprostatically and ciprofloxacin orally is able to offer a best control on infections caused by fluoroquinolone-resistant E. coli.
authors.affiliation: San Donato Milanese Hospital, Morandi Street, San Donato Milanese, Milan, Italy. giannapace@gmail.com
authors.forename: Gianna
authors.initials: G
authors.lastname: Pace
authors.forename: Luca
authors.initials: L
authors.lastname: Carmignani
authors.forename: Carlo
authors.initials: C
authors.lastname: Marenghi
authors.forename: Gabriella
authors.initials: G
authors.lastname: Mombelli
authors.forename: Giorgio
authors.initials: G
authors.lastname: Bozzini
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D019072:Antibiotic Prophylaxis; D001707:Biopsy, Needle / Q000009:adverse effects*; D002511:Cephalosporins / Q000008:administration & dosage*; D004311:Double-Blind Method; D005500:Follow-Up Studies; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011467:Prostate / Q000473:pathology; D011472:Prostatitis / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D018805:Sepsis / Q000517:prevention & control; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins