Prospective Study of Antibiotic Prophylaxis for Prostate Biopsy Involving >1100 Men

Abstract EN

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.