Quinolone prophylaxis in transrectal ultrasound guided prostate biopsy: an eight-year single center experience.
We retrospectively evaluated the efficacy of prophylaxis with pipemidic acid and levofloxacin in transrectal ultrasound guided prostate biopsy (TRUSP-Bx). From January 2002 to December 2004, patients receiving oral pipemidic acid 500 mg twice daily for three days with or without a preoperative intravenous cefazolin 1 gm injection comprised group A. Between January 2005 and December 2009, patients receiving oral levofloxacin 500 mg one hour before biopsy comprised group B. We calculated the annual febrile urinary tract infection (fUTI) rates. Patients' characteristics, including age, prophylactic antibiotics, biopsy core numbers, pathologic results, PSA, and the spectrums and susceptibility of pathogens, were also evaluated. A total of 1313 (35.5%) patients belonged to group A, while 2381 (64.5%) patients belonged to group B. Seventy-three patients experienced postoperative infectious complications. There was a significant difference in the fUTI rate between groups A and B (3.7% versus 1.0%, P < 0.001). The yearly fUTI rates varied from 0.6 to 3.9% between 2002 and 2009. Of the 73 patients with fUTI, those receiving levofloxacin prophylaxis were more likely to harbor fluoroquinolone-resistant pathogens (P < 0.001). E. coli was the most common pathogen in both groups. Levofloxacin remains effective and appears superior to pipemidic acid based prophylaxis.
Department of Urology, National Taiwan University Hospital, College of Medicine, National Taiwan University, No. 7, Chung Shan S. Road (Zhongshan S. Road), Zhongzheng District, Taipei City 10002, Taiwan ; Department of Urology, Cardinal Tien Hospital, College of Medicine, Fu Jen Catholic University, No. 362, Zhongzheng Road, Xindian District, New Taipei City 231, Taiwan.
Bing-Juin
BJ
Chiang
Department of Urology, National Taiwan University Hospital, College of Medicine, National Taiwan University, No. 7, Chung Shan S. Road (Zhongshan S. Road), Zhongzheng District, Taipei City 10002, Taiwan.
Yeong Shiau
YS
Pu
Department of Urology, National Taiwan University Hospital, College of Medicine, National Taiwan University, No. 7, Chung Shan S. Road (Zhongshan S. Road), Zhongzheng District, Taipei City 10002, Taiwan ; Division of Urology, Department of Surgery, Far Eastern Memorial Hospital, No. 21, Section 2, Nanya S. Road, Banqiao District, New Taipei City 220, Taiwan ; Department of Urology, Tzu Chi General Hospital, No. 707, Section 3, Chung Yang Road, Hualien 970, Taiwan.
Shiu-Dong
SD
Chung
Department of Urology, National Taiwan University Hospital, College of Medicine, National Taiwan University, No. 7, Chung Shan S. Road (Zhongshan S. Road), Zhongzheng District, Taipei City 10002, Taiwan.
Shih-Ping
SP
Liu
Department of Urology, National Taiwan University Hospital, College of Medicine, National Taiwan University, No. 7, Chung Shan S. Road (Zhongshan S. Road), Zhongzheng District, Taipei City 10002, Taiwan.
Hong-Jeng
HJ
Yu
Department of Urology, National Taiwan University Hospital, College of Medicine, National Taiwan University, No. 7, Chung Shan S. Road (Zhongshan S. Road), Zhongzheng District, Taipei City 10002, Taiwan.
Shuo-Meng
SM
Wang
Department of Urology, National Taiwan University Hospital, College of Medicine, National Taiwan University, No. 7, Chung Shan S. Road (Zhongshan S. Road), Zhongzheng District, Taipei City 10002, Taiwan.
Hong-Chiang
HC
Chang
Department of Urology, National Taiwan University Hospital, College of Medicine, National Taiwan University, No. 7, Chung Shan S. Road (Zhongshan S. Road), Zhongzheng District, Taipei City 10002, Taiwan.
I-Ni
IN
Chiang
Department of Urology, National Taiwan University Hospital, College of Medicine, National Taiwan University, No. 7, Chung Shan S. Road (Zhongshan S. Road), Zhongzheng District, Taipei City 10002, Taiwan.
Chao-Yuan
CY
Huang
D019072:Antibiotic Prophylaxis / Q000379:methods*; D001706:Biopsy / Q000009:adverse effects / Q000379:methods*; D002437:Cefazolin / Q000627:therapeutic use; D006801:Humans; D064704:Levofloxacin / Q000627:therapeutic use*; D008297:Male; D010876:Pipemidic Acid / Q000627:therapeutic use*; D011467:Prostate / Q000473:pathology*; D012189:Retrospective Studies; D013624:Taiwan; D036761:Ultrasound, High-Intensity Focused, Transrectal / Q000009:adverse effects / Q000379:methods*; D014552:Urinary Tract Infections / Q000473:pathology / Q000517:prevention & control*
D064704:Levofloxacin; D002437:Cefazolin; D010876:Pipemidic Acid