Antibiotic prophylaxis with intravenous ceftriaxone and fluoroquinolone reduces infectious complications after transrectal ultrasound-guided prostatic biopsy.
10.4111/kju.2015.56.6.466
- Author:
Chunwoo LEE
1
;
Dalsan YOU
;
In Gab JEONG
;
Jun Hyuk HONG
;
Myung Soo CHOO
;
Hanjong AHN
;
Tai Young AHN
;
Choung Soo KIM
Author Information
1. Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. cskim@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Antibiotic prophylaxis;
Biopsy;
Ceftriaxone;
Infection;
Prostate
- MeSH:
Adolescent;
Adult;
Aged;
Aged, 80 and over;
Antibiotic Prophylaxis/*methods;
Biopsy, Needle/adverse effects/methods;
Ceftriaxone/*therapeutic use;
Cross Infection/epidemiology/etiology/*prevention & control;
Drug Evaluation/methods;
Drug Resistance, Bacterial;
Drug Therapy, Combination;
Escherichia coli/drug effects;
Escherichia coli Infections/epidemiology/prevention & control;
Fluoroquinolones/*therapeutic use;
Humans;
Incidence;
Male;
Middle Aged;
Prostatic Neoplasms/*pathology;
Republic of Korea/epidemiology;
Retrospective Studies;
Ultrasonography, Interventional;
Young Adult
- From:Korean Journal of Urology
2015;56(6):466-472
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To assess the rates of infectious complications before and after the change of prophylactic antibiotic regimens in prostate needle biopsy. MATERIALS AND METHODS: The records of 5,577 patients who underwent prostate needle biopsy at Asan Medical Center between August 2005 and July 2012 were retrospectively reviewed. Group 1 (n=1,743) included patients treated between 2005 and 2009 with fluoroquinolone for 3 days, group 2 (n=2,723) included those treated between 2009 and 2012 with ceftriaxone once before the biopsy and fluoroquinolone before biopsy and continue therapy for 3 days, and group 3 (n=1,111) received the same treatment for more than 7 days after the biopsy. Univariable and multivariable logistic regression models addressed risk factors associated with infectious complication after prostate needle biopsy. RESULTS: Infectious complication after prostate needle biopsy developed in 18 (group 1), seven (group 2), and two patients (group 3) (p=0.001). In group 1, seven patients with infectious complication had positive blood cultures and harbored fluoroquinolone-resistant Escherichia coli, four had ceftriaxone susceptible isolates, and three had extended spectrum beta-lactamase-positive E. coli. Two patients in group 1 required intensive care because of septic shock. In multivariable analysis, the patients with combination of fluoroquinolone and ceftriaxone had significantly lower infectious complication rate than the fluoroquinolon alone (p=0.003). CONCLUSIONS: Antibiotic prophylaxis with ceftriaxone and fluoroquinolone before prostate needle biopsy decreased the risk of potentially serious infectious complications.
