Prospective study of antibiotic prophylaxis for prostate biopsy involving >1100 men.
We aimed to compare infection rates for two 3-day antibiotic prophylaxis regimens for transrectal ultrasound-guided prostate biopsy (TRUSgbp) and demonstrate local microbiological trends. In 2008, 558 men and, in 2009, 625 men had TRUSgpb. Regimen 1 (2008) comprised 400 mg Ofloxacin immediately before biopsy and 200 mg 12-hourly for 3 days. Regimen 2 (2009) comprised Ofloxacin 200 mg 12-hourly for 3 days commencing 24 hours before biopsy. 20/558 (3.6%) men had febrile episodes with regimen 1 and 10/625 (1.6%) men with regimen 2 (P = 0.03). E. coli was the most frequently isolated organism. Overall, 7/13 (54%) of positive urine cultures were quinolone resistant and (5/13) 40% were multidrug resistant. Overall, 5/9 (56%) patients with septicaemia were quinolone resistant. All patients were sensitive to Meropenem. There was 1 (0.2%) death with regimen 1. Commencing Ofloxacin 24 hours before TRUSgpb reduced the incidence of febrile episodes significantly. We observed the emergence of quinolone and multidrug-resistant E. coli. Meropenem should be considered for unresolving sepsis.
Department of Urology, Adelaide and Meath Hospital, Tallaght, Dublin 24, Ireland. rustom.manecksha@gmail.com
Rustom P
RP
Manecksha
Gregory J
GJ
Nason
Ivor M
IM
Cullen
Jérôme P
JP
Fennell
Elizabeth
E
McEvoy
Ted
T
McDermott
Robert J
RJ
Flynn
Ronald
R
Grainger
John A
JA
Thornhill
D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis / Q000379:methods*; D001706:Biopsy / Q000379:methods*; D002511:Cephalosporins / Q000627:therapeutic use; D024881:Drug Resistance, Bacterial; D018432:Drug Resistance, Multiple; D005334:Fever; D006801:Humans; D008297:Male; D000077731:Meropenem; D008875:Middle Aged; D015242:Ofloxacin / Q000627:therapeutic use; D011446:Prospective Studies; D011467:Prostate / Q000473:pathology / Q000601:surgery*; D011471:Prostatic Neoplasms / Q000175:diagnosis; D015363:Quinolones / Q000627:therapeutic use; D018805:Sepsis / Q000188:drug therapy; D013845:Thienamycins / Q000627:therapeutic use; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D015363:Quinolones; D013845:Thienamycins; D015242:Ofloxacin; D000077731:Meropenem