Determinants of complications after multiple transrectal core biopsies of the prostate

Abstract

Transrectal ultrasound-guided biopsies of the prostate were performed on 347 consecutive men. All patients were given prophylactic antibiotics. The first 199 patients received 400 mg norfloxacin immediately after the biopsies were performed and 400 mg the same evening. The second group of 148 patients received 400 mg of norfloxacin 1 h before the examination followed by five doses administered twice daily. A total of 15 major complications were noted. In the first group the complication rate was 6.5% and in the second group 1.4%. The different regimes of prophylactic antibiotic treatment were the only parameters shown to have a statistically significant impact on the complication rate. The number of complications decreased, but were not eliminated, when prophylactic treatment with norfloxacin was given before the biopsies were taken and continued for a total of 3 days.

Antibiotic prophylaxis for prostate biopsy: benefits and costs

“…The value of quinolones as an effective agent against aerobic infections has been demonstrated by several recent studies. 11,12 Anaerobic infections following transrectal prostatic biopsy have also been reported. 10,13 Although rare, such infections may threat the patient's life and this was the rationale for the additional use of metronidazole in this present study.…”

“…Such a regime design is supported by recent reports. 11,12 Theoretically such a regime permits a short course of treatment and may also be advantageous from the point of patient compliance as well as health economy, if shown to be ef®cient. In this present study using such a regime we veri®ed infections in 1.7% of the patients.…”

Estrategias para la biopsia de próstata: Revisión de la literatura

“…La duración del tratamiento oral después de la biopsia también es objeto de controversia y hay estudios que sostienen que la duración de tres o cuatro días de tratamiento oral disminuye de forma significativa la tasa de complicaciones infecciosas [40][41][42] .…”

Prospective Randomized Controlled Study of the Results of Medication with Oral Ciprofloxacin versus Oralcefixime to Prevent Transient Bacteraemia and Adverse Events from Trans-Rectal Prostatic Biopsy

“…Currently, many urologists use prophylactic antibiotic therapy to minimize infective complications after trans-rectal prostatic biopsy, but such therapy does not completely eliminate infection. The reported infection rate varies considerably in studies using different antibiotic regimens (8)(9)(10)(11)(12)(13). Nowadays, we prescribe the oral form of ciprofloxacin because the drug, also called fluoroquinolone, is broad spectrum and penetrates the prostate gland well.…”