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Antibiotic prophylaxis for transrectal ultrasound-guided prostatic biopsies: a comparison of two regimens

Authors
  • Faty, Mostafa1
  • Saleh, Saleh M.1
  • El-Nahas, Ahmed R.1
  • Al-Shaiji, Tariq F.1
  • Al-Terki, Abdullatif1
  • 1 Al-Amiri Hospital, Gulf Road, Sharq, Kuwait City, 20002, Kuwait , Kuwait City (Kuwait)
Type
Published Article
Journal
African Journal of Urology
Publisher
Springer Berlin Heidelberg
Publication Date
May 04, 2020
Volume
26
Issue
1
Identifiers
DOI: 10.1186/s12301-020-00026-9
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundThere were controversies about the appropriate antibiotic prophylaxis regimen in order to decrease the incidence of post-transrectal ultrasound-guided prostatic biopsies (TRUS-PB) infectious complications. This study was conducted to compare the efficacy of two antibiotics prophylaxis regimens for TRUS-PB. In group 1, patients received single IV dose of 1 g amikacin 30 min before the procedure followed by oral ciprofloxacin 500 mg immediately after TRUS-PB. Group 2 patients received the same antibiotics, but ciprofloxacin started 1 day prior to TRUS-PB. Then ciprofloxacin was given twice daily for a total of 5 days in both groups.ResultsThe study included 146 patients (54 in group 1 and 92 in group 2). The baseline characters (age, comorbidities, ASA score, PSA, prostate size and presence of urethral catheter) were comparable for both groups. Post-biopsy sepsis was observed in three patients (5.6%) in group 1 and one patient in group 2 (1.1%, P = 0.143). Sepsis was successfully managed in three, while one patient (1.9%) from group 1 required ICU admission for management of septic shock.ConclusionsThe incidence of sepsis after TRUS-PB is low when dual antibiotic prophylaxis (ciprofloxacin and amikacin) was used. Starting ciprofloxacin 1 day before TRUS-PB decreased the incidence of sepsis as well as its severity.

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