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. 2020;73(4):544-550.
doi: 10.5173/ceju.2020.0072. Epub 2020 Oct 10.

Cefixime versus prulifloxacin as a prophylactic treatment for prostate biopsy: a randomized study

Michael Samarinas  1 , Konstantinos Skriapas  1 , Iraklis Mitsogiannis  2 , Stavros Gravas  2 , Anastasios Karatzas  1 , Vasileios Tzortzis  3
Affiliations

Cefixime versus prulifloxacin as a prophylactic treatment for prostate biopsy: a randomized study

Michael Samarinas et al. Cent European J Urol. 2020.

Abstract

Introduction: Urinary tract infections may be a severe complication after prostate biopsy. The aim of our study is to investigate the efficacy of cefixime versus prulifloxacin, as a prophylactic treatment in the era of fluoroquinolone resistance.

Material and methods: In this prospective randomized trial, patients were allocated into two groups. In Group A, patients received cefixime 400 mg p.o./day, while in Group B, prulifoxacin 600 mg p.o./day, both for three days, starting the day before procedure. Eligible for the study were men with a high prostate-specific antigen (PSA) and/or a positive rectal examination. Exclusion criteria were allergy to cefixime or fluoroquinolones, low glomerular filtration rate and drug-resistance to these antibiotics. Patients were followed-up for seven days.

Results: Finally, 120 patients were divided into 2 groups of 60 patients with a mean age of 68.6 years. A total of 16 (13.3%) men had already undergone another biopsy in the past, while 18 (15%) had received prulifloxacin and 8 (6.67%) cefixime, at least once in the last three months. During follow-up, hospital admission due to a severe urinary tract infection (UTI) was required in 2 of 60 (1.3%) and 1 of 60 (1.67%) patients from Group B and A respectively. The bacterial specimens detected in those urine cultures were resistant to prulifloxacin or cefixime. Among the remaining 117 patients (97.5%), nobody presented with a UTI.

Conclusions: Prophylactic cefixime could be suggested as effective in preventing severe UTIs after prostate biopsy in the era of high bacterial resistance to fluoroquinolones.

Keywords: antibiotics; fluoroquinolone; prostate biopsy; urinary tract infection.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
CONSORT Flow Diagram.
See this image and copyright information in PMC

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