title: The real practice of antibiotic prophylaxis for prostate biopsy in Korea where the prevalence of quinolone-resistant Escherichia coli is high.
abstract: OBJECTIVE
  Transrectal ultrasonography-guided prostate biopsy (TRUS-Bx) is an essential procedure for diagnosing prostate cancer. The American Urological Association (AUA) Guideline recommends fluoroquinolone alone for 1 day during TRUS-Bx. However, this recommendation may not be appropriate in regions where the prevalence of quinolone-resistant Escherichia coli is high. We investigated the real practice of antibiotic prophylaxis for TRUS-Bx in Korea.
  
  
  METHODS
  A total of 77 hospitals performing TRUS-Bx were identified and an e-mail was sent to the Urology Department of those hospitals. The questions in the e-mail included the choice of antibiotics before and after the procedure and the duration of antibiotic therapy after TRUS-Bx.
  
  
  RESULTS
  A total of 54 hospitals (70.0%) responded to the e-mail. Before TRUS-Bx, all hospitals administered intravenous antibiotic prophylaxis. The percentage of hospitals that used quinolone, cephalosporin, and aminoglycoside alone was 48.1%, 20.4%, and 9.3%, respectively. The percentage of hospitals that used two or more antibiotics was 22.2%. After biopsy, all 54 hospitals prescribed oral antibiotics. The percentage of hospitals that prescribed quinolone alone, cephalosporin alone, or a combination of two or more antibiotics was 77.8%, 20.4%, and 1.8%, respectively. The duration of antibiotic use was more than 3 days in most hospitals (79.6%). Only four hospitals (7.4%) followed the AUA recommendation of a 1-day regimen.
  
  
  CONCLUSIONS
  The AUA recommendation was not followed by most hospitals in Korea. This clinical behavior might reflect the high quinolone resistance rate in Korea, and further studies on the most efficient prophylactic antibiotics after TRUS-Bx in Korea are warranted.
authors.affiliation: Departement of Urology, Konkuk University Medical Center, Seoul, Korea.
authors.forename: Dae Hyun
authors.initials: DH
authors.lastname: Kim
authors.affiliation: Departement of Urology, The Catholic University of Korea, Uijeongbu St. Mary's Hospital, Uijeongbu, Korea.
authors.forename: Sang Rak
authors.initials: SR
authors.lastname: Bae
authors.affiliation: Departement of Urology, Konkuk University Medical Center, Seoul, Korea.
authors.forename: Woo Suk
authors.initials: WS
authors.lastname: Choi
authors.affiliation: Departement of Urology, Konkuk University Medical Center, Seoul, Korea.
authors.forename: Hyoung Keun
authors.initials: HK
authors.lastname: Park
authors.affiliation: Departement of Urology, Konkuk University Medical Center, Seoul, Korea.
authors.forename: Sung Hyun
authors.initials: SH
authors.lastname: Paick
authors.affiliation: Departement of Urology, Konkuk University Medical Center, Seoul, Korea.
authors.forename: Hyeong Gon
authors.initials: HG
authors.lastname: Kim
authors.affiliation: Departement of Urology, Konkuk University Medical Center, Seoul, Korea.
authors.forename: Yong Soo
authors.initials: YS
authors.lastname: Loh
mesh_terms: D000617:Aminoglycosides / Q000008:administration & dosage*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D019072:Antibiotic Prophylaxis / Q000379:methods*; D001706:Biopsy / Q000009:adverse effects; D002511:Cephalosporins / Q000008:administration & dosage*; D003430:Cross-Sectional Studies; D024881:Drug Resistance, Bacterial; D004927:Escherichia coli Infections / Q000517:prevention & control*; D006801:Humans; D008297:Male; D011467:Prostate / Q000473:pathology; D011471:Prostatic Neoplasms / Q000473:pathology; D015363:Quinolones / Q000008:administration & dosage*; D056910:Republic of Korea
chemical_list: D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D015363:Quinolones
keywords: Antibiotic prophylaxis; Biopsy; Guideline