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. 2012:2012:650858.
doi: 10.1100/2012/650858. Epub 2012 May 2.

Prospective study of antibiotic prophylaxis for prostate biopsy involving >1100 men

Rustom P Manecksha  1 , Gregory J Nason, Ivor M Cullen, Jérôme P Fennell, Elizabeth McEvoy, Ted McDermott, Robert J Flynn, Ronald Grainger, John A Thornhill
Affiliations

Prospective study of antibiotic prophylaxis for prostate biopsy involving >1100 men

Rustom P Manecksha et al. ScientificWorldJournal. 2012.

Abstract

We aimed to compare infection rates for two 3-day antibiotic prophylaxis regimens for transrectal ultrasound-guided prostate biopsy (TRUSgbp) and demonstrate local microbiological trends. In 2008, 558 men and, in 2009, 625 men had TRUSgpb. Regimen 1 (2008) comprised 400 mg Ofloxacin immediately before biopsy and 200 mg 12-hourly for 3 days. Regimen 2 (2009) comprised Ofloxacin 200 mg 12-hourly for 3 days commencing 24 hours before biopsy. 20/558 (3.6%) men had febrile episodes with regimen 1 and 10/625 (1.6%) men with regimen 2 (P = 0.03). E. coli was the most frequently isolated organism. Overall, 7/13 (54%) of positive urine cultures were quinolone resistant and (5/13) 40% were multidrug resistant. Overall, 5/9 (56%) patients with septicaemia were quinolone resistant. All patients were sensitive to Meropenem. There was 1 (0.2%) death with regimen 1. Commencing Ofloxacin 24 hours before TRUSgpb reduced the incidence of febrile episodes significantly. We observed the emergence of quinolone and multidrug-resistant E. coli. Meropenem should be considered for unresolving sepsis.

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