title: Preprostate Biopsy Rectal Culture and Postbiopsy Sepsis.
abstract: Transrectal ultrasound-guided biopsy of the prostate (TRUSP) remains the primary procedure for the accurate histologic diagnosis of prostate cancer. Fluoroquinolones (FQs) are still recommended as the agents of choice for antimicrobial prophylaxis for TRUSP despite the alarming increasing incidence of FQ-resistant organisms among men undergoing TRUSP. This article reviews the current TRUSP antimicrobial prophylaxis guidelines, antimicrobial resistance and its implications for these guidelines, the incidence of post-TRUSP infectious complications including urosepsis, the seminal data supporting pre-TRUSP rectal swab (RS), RS technique and protocol, and the current available literature surrounding the efficacy of RS in reducing post-TRUSP infectious complications.
authors.affiliation: Department of Urology, University of Pittsburgh Medical Center, 300 Halket Street, Suite 4710, Pittsburgh, PA 15213, USA. Electronic address: taylora10@upmc.edu.
authors.forename: Aisha Khalali
authors.initials: AK
authors.lastname: Taylor
authors.affiliation: Department of Urology, Northwestern Memorial Hospital, 303 East Chicago Avenue, Tarry Building Room 16-703, Chicago, IL 60611, USA.
authors.forename: Adam Bryant
authors.initials: AB
authors.lastname: Murphy
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis / Q000379:methods / Q000592:standards*; D016470:Bacteremia / Q000517:prevention & control; D015169:Colony Count, Microbial / Q000592:standards; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000009:adverse effects*; D024841:Fluoroquinolones / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D017410:Practice Guidelines as Topic; D011300:Preoperative Care / Q000379:methods / Q000592:standards; D011467:Prostate / Q000473:pathology*; D012007:Rectum / Q000382:microbiology*; D014552:Urinary Tract Infections / Q000517:prevention & control
chemical_list: D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones
keywords: Biopsy; Drug resistance; Prostate; Rectal swab; Targeted antimicrobial prophylaxis; Urosepsis