title: A single dose of 240 mg gentamicin during transrectal prostate biopsy significantly reduces septic complications.
abstract: OBJECTIVE
  To evaluate whether the addition of a single dose of an aminoglycoside to a fluoroquinolone-based prophylaxis regime would decrease septic complications associated with transrectal prostate biopsy.
  
  
  METHODS
  A retrospective survey of all patients undergoing transrectal ultrasound guided prostate biopsy (TRUS-PB) between 2001 and 2012 at Hadassah Hebrew University Medical Center was performed. All patients received prophylactic ofloxacin for 3 days. From 2008, patients received an augmented protocol, consisting also of a single injection of gentamicin. The dose of the aminoglycoside was left to the discretion of the attending physician.
  
  
  RESULTS
  Of 4655 patients, 110 patients (2.4%) were admitted because of urosepsis. Ninety patients (82%) had a positive urine or blood culture or both. From 2008, among 581 patients treated solely with ofloxacin, the infection rate was 3.6%, and among the 538 patients who also received 80 mg gentamicin, the rate of sepsis was 3.5% (P = 1.0). Among the 376 patients treated with gentamicin, 160 mg infection rate was 2.7% (P = .27). The sepsis rate dropped significantly to 0.6% (P = .04) among the 169 patients who received 240 mg gentamicin during the biopsy.
  
  
  CONCLUSIONS
  Addition of a single dose of gentamicin 240 mg resulted in a significant drop in infection rates after TRUS-PB. However, addition of 80 mg or 160 mg gentamicin had no significant effect on the infection rates. We recommend adding a single dose of gentamicin 240 mg to all patients with normal kidney function undergoing TRUS-PB during the procedure.
authors.affiliation: Department of Urology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel. Electronic address: glorber@hotmail.com.
authors.forename: Gideon
authors.initials: G
authors.lastname: Lorber
authors.forename: Shmuel
authors.initials: S
authors.lastname: Benenson
authors.forename: Shilo
authors.initials: S
authors.lastname: Rosenberg
authors.forename: Ofer N
authors.initials: ON
authors.lastname: Gofrit
authors.forename: Dov
authors.initials: D
authors.lastname: Pode
mesh_terms: D000368:Aged; D000617:Aminoglycosides / Q000008:administration & dosage*; D019072:Antibiotic Prophylaxis / Q000379:methods*; D001706:Biopsy; D024841:Fluoroquinolones / Q000627:therapeutic use; D005839:Gentamicins / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000000981:diagnostic imaging* / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000378:metabolism; D011471:Prostatic Neoplasms / Q000175:diagnosis*; D012189:Retrospective Studies; D018805:Sepsis / Q000517:prevention & control*; D014463:Ultrasonography
chemical_list: D000617:Aminoglycosides; D024841:Fluoroquinolones; D005839:Gentamicins; D017430:Prostate-Specific Antigen