The clinical importance of antibiotic regimen in prostate biopsy: a single center analysis of more than 10,000 cases
INTRODUCTION
This study aims to evaluate the effectiveness of an antibiotic regimen for prostate biopsy by analyzing patients who were hospitalized due to complications after transrectal ultrasound-guided prostate biopsy.
METHODS
We retrospectively reviewed the medical records of 10,339 patients who underwent transrectal ultrasound-guided prostate biopsy at our institution from May 2003 to April 2017. We excluded patients with low quality data. All patients underwent urine culture before transrectal ultrasound-guided prostate biopsy and received IV antibiotics 30-60 minutes before biopsy. Patients were either given prophylactic quinolone or prophylactic second or third generation cephalosporin. Clinicopathologic factors including patient age, antibiotic regimen, number of biopsy cores, body mass index, prostate specific antigen, prostate volume, and infection-related complications that required hospitalization were subsequently analyzed.
RESULTS
A total of 9,487 patients were included in the final analysis, of which 33 patients (0.35%) were hospitalized due to infection-related complications. Infection-related hospitalization rates were significantly lower in patients who received cephalosporin (0.2%) than in patients who received quinolone (1.64%). At out institution, cephalosporin has been predominantly used to prevent post-biopsy infections since January 2013. Only five patients (0.12%) developed post-operative complications out of the 3,863 patient who underwent transrectal ultrasound-guided prostate biopsy. Multivariate analysis revealed that use of second or third generation cephalosporin was the only independent predictor of infection-related complications.
CONCLUSION
mplementing an effective antibiotic prophylaxis regimen at our institution by using second or third generation cephalosporin could significantly reduce infection-related complications after transrectal ultrasound-guided prostate biopsy.
Funding: none