1.Antibiotic prophylaxis with intravenous ceftriaxone and fluoroquinolone reduces infectious complications after transrectal ultrasound-guided prostatic biopsy.
Chunwoo LEE ; Dalsan YOU ; In Gab JEONG ; Jun Hyuk HONG ; Myung Soo CHOO ; Hanjong AHN ; Tai Young AHN ; Choung Soo KIM
Korean Journal of Urology 2015;56(6):466-472
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.
Adolescent
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Adult
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Aged
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Aged, 80 and over
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Antibiotic Prophylaxis/*methods
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Biopsy, Needle/adverse effects/methods
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Ceftriaxone/*therapeutic use
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Cross Infection/epidemiology/etiology/*prevention & control
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Drug Evaluation/methods
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Drug Resistance, Bacterial
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Drug Therapy, Combination
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Escherichia coli/drug effects
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Escherichia coli Infections/epidemiology/prevention & control
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Fluoroquinolones/*therapeutic use
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Humans
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Incidence
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Male
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Middle Aged
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Prostatic Neoplasms/*pathology
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Republic of Korea/epidemiology
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Retrospective Studies
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Ultrasonography, Interventional
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Young Adult