title: Single-dose versus multiple-dose ciprofloxacin plus metronidazole prophylaxis in transrectal ultrasound-guided biopsy of the prostate: a randomized controlled trial.
abstract: To investigate and compare the infectious and non-infectious complications of single-dose versus multiple-dose antibiotic therapy for trans-rectal ultrasound (TRUS)-guided biopsy of the prostate. Patients were enrolled in a prospective randomized study that was designed to investigate the effects of single-dose versus multiple-dose antimicrobial prophylaxis regimen mainly on asymptomatic bacteriuria, urinary tract infection (UTI) without fever, fever and urinary septicemia. The single-dose group received one ciprofloxacin 500 mg tablet and two metronidazole 250 mg tablets at 2 hours before the biopsy, while the multiple-doses group received those every 12 hours from 3 days before the biopsy. One-hundred and sixty patients were evaluated in two groups and bacteriuria in urinalysis was encountered in 12 patients (15%) in the single-dose group and four patients (5%) in the multiple-dose group, with a significant difference (P=0.035). UTI without fever occurred in six patients (7.5%) in the single-dose group and one patient (1.25%) in the multiple-dose group, with no significant difference (borderline P=0.053). After biopsy, three patients (3.75%) returned with fever due to UTI and bacteremia in the single-dose group and none in the multiple-dose group, but with no significant difference (P=0.08). Regarding non-infectious complications, there were no significant differences between the two groups. Using prophylactic antibiotics for prostate biopsy in multiple doses, and at least 3 days before the procedure significantly reduces the rate of bacteriuria compared with a single-dose regimen.
authors.affiliation: Department of Urology, Hasheminejad Hospital, Iran University of Medical Sciences, Tehran, Iran. zhoobin.h.bateni@gmail.com.
authors.forename: Zhoobin
authors.initials: Z
authors.lastname: Heidari Bateni
authors.affiliation: Department of Urology, Hasheminejad Hospital, Iran University of Medical Sciences, Tehran, Iran. zhoobin.h.bateni@gmail.com.
authors.forename: Hossein
authors.initials: H
authors.lastname: Shahrokh
authors.affiliation: Department of Urology, Hasheminejad Hospital, Iran University of Medical Sciences, Tehran, Iran. zhoobin.h.bateni@gmail.com.
authors.forename: Hormoz
authors.initials: H
authors.lastname: Salimi
authors.affiliation: Department of Urology, Hasheminejad Hospital, Iran University of Medical Sciences, Tehran, Iran. zhoobin.h.bateni@gmail.com.
authors.forename: Hossein
authors.initials: H
authors.lastname: Safari
authors.affiliation: Department of Urology, Hasheminejad Hospital, Iran University of Medical Sciences, Tehran, Iran. zhoobin.h.bateni@gmail.com.
authors.forename: Meghdad
authors.initials: M
authors.lastname: Tabatabai
authors.affiliation: Department of Radiology, Hasheminejad Hospital, Iran University of Medical Sciences, Tehran, Iran. zhoobin.h.bateni@gmail.com.
authors.forename: Dariush
authors.initials: D
authors.lastname: Saedi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis / Q000379:methods; D016470:Bacteremia / Q000453:epidemiology / Q000517:prevention & control*; D001424:Bacterial Infections / Q000453:epidemiology / Q000517:prevention & control*; D001706:Biopsy / Q000379:methods; D002939:Ciprofloxacin / Q000008:administration & dosage / Q000627:therapeutic use; D005334:Fever / Q000453:epidemiology / Q000209:etiology; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000008:administration & dosage / Q000627:therapeutic use; D008875:Middle Aged; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000175:diagnosis*; D018805:Sepsis / Q000453:epidemiology / Q000517:prevention & control; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000517:prevention & control
chemical_list: D000900:Anti-Bacterial Agents; D008795:Metronidazole; D002939:Ciprofloxacin