Comparison of fosfomycin against fluoroquinolones for transrectal prostate biopsy prophylaxis: an individual patient-data meta-analysis

Roberts, Matthew J.; Scott, Shannon L.; Harris, Patrick N A; Naber, Kurt G.; Wagenlehner, Florian; Doi, Suhail A.R.

doi:10.1007/s00345-017-2163-9

Cited by 43 publications

(38 citation statements)

References 36 publications

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“…The benefit of FT reported here has been observed in other studies, including a meta‐analysis with 3112 patients that showed a significantly lower number of infectious complications in those treated with FT . Importantly, fewer infections were noted in patients who had confirmed FQ resistance and were given FT in preference to FQ.…”

supporting

confidence: 77%

“…Concern regarding TRUSPB‐related infections despite antimicrobial prophylaxis, chiefly due to the development of fluoroquinolone (FQ) resistance, has prompted the development of adjunct prophylaxis methods and biopsy approaches . Fosfomycin trometamol (FT) has long been used in the USA and Europe with broad‐spectrum bactericidal coverage and adequate prostatic soft tissue concentrations, and has been shown to reduce TRUSPB‐related infections compared with FQ‐based prophylaxis …”

mentioning

confidence: 99%

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Editorial Comment from Dr Macdonald and Dr Roberts to Use of fosfomycin as targeted antibiotic prophylaxis before prostate biopsy: A prospective randomized study

Macdonald

Roberts

2019

Int J of Urology

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supporting

confidence: 77%

mentioning

confidence: 99%

Editorial Comment from Dr Macdonald and Dr Roberts to Use of fosfomycin as targeted antibiotic prophylaxis before prostate biopsy: A prospective randomized study

Macdonald

Roberts

2019

Int J of Urology

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“…Recently, several studies have investigated the potential of fosfomycin as a prophylactic antibiotic in prostate biopsies . Pooled results from five studies containing 3112 patients in a recent meta‐analysis showed that the relative odds of an infectious complication (OR 0.22, 95% CI 0.09–0.54) was significantly lower in those receiving fosfomycin compared with FQ prophylaxis . In the present study, 22 patients with FQ bacteria in the intervention group received fosfomycin without infectious complications after TRPB.…”

Section: Discussionmentioning

confidence: 64%

Use of fosfomycin as targeted antibiotic prophylaxis before prostate biopsy: A prospective randomized study

et al. 2018

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Objectives To investigate whether switching ciprofloxacin to fosfomycin in the case of fluoroquinolone‐resistant rectal bacteria influences the incidence of infectious complications after transrectal prostate biopsy. Methods From December 2015 until December 2017, patients undergoing prostate biopsy were randomly assigned to a control group or an intervention group in a prospective, open‐label fashion at three different centers. The presence of fluoroquinolone‐resistant organisms was detected by rectal swabs. Patients in the control group received ciprofloxacin. Patients in the intervention group received fosfomycin instead of ciprofloxacin in the case of fluoroquinolone‐resistant bacteria on rectal swab culture. The primary end‐point was the difference in occurrence of major (febrile) and minor (afebrile) infections between both groups. Results A total of 102 patients were randomized to the control group, and 102 patients to the intervention group. In the control group, nine complications occurred, of which five were major febrile complications. In the intervention group, six complications occurred, of which four were major febrile complications. The total number of complications (major and minor) did not differ between both groups (P = 0.59). A subgroup analysis of patients with fluoroquinolone‐resistant bacteria on rectal swab showed five complications in the control group and one complication in the intervention group (P = 0.09). Conclusions This represents the first prospective randomized study using rectal cultures for targeted antibiotic prophylaxis. Study findings show promising results for use of fosfomycin in patients with fluoroquinolone resistance.

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“…After a median follow up of 20 months, seven patients (47%) had a clinical response . Fosfomycin may also prove to be a useful alternative in the prevention of trans‐rectal ultrasound‐guided prostate biopsy‐related infectious complications in patients with a high risk of quinolone resistance …”

Section: Mechanism Of Action and Antimicrobial Activity And Resistancementioning

confidence: 99%

Fosfomycin: what was old is new again

Avent

Rogers

Cheng

et al. 2018

Internal Medicine Journal

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Comparison of fosfomycin against fluoroquinolones for transrectal prostate biopsy prophylaxis: an individual patient-data meta-analysis

Cited by 43 publications

References 36 publications

Editorial Comment from Dr Macdonald and Dr Roberts to Use of fosfomycin as targeted antibiotic prophylaxis before prostate biopsy: A prospective randomized study

Editorial Comment from Dr Macdonald and Dr Roberts to Use of fosfomycin as targeted antibiotic prophylaxis before prostate biopsy: A prospective randomized study

Use of fosfomycin as targeted antibiotic prophylaxis before prostate biopsy: A prospective randomized study

Fosfomycin: what was old is new again

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