Prophylactic antibiotics reduce sepsis after biopsy of the prostate - Abstract

INTRODUCTION: Prostate cancer is the most common form of cancer in Danish men, and the incidence is rising.

The diagnosis is made by transrectal prostate biopsy guided by ultrasound. This procedure has several complications, the most severe being sepsis. In our department, this is sought prevented by administering the prophylactic antibiotics metronidazol and ciprofloxacin. This study examined the rate of sepsis in patients who had the procedure performed at our department.

METHODS: The electronic patient records of all patients who had transrectal ultrasound of the prostate with biopsies performed at the Department of Urology at Naestved Hospital in the period from 1 May 2009 to 31 May 2011 were examined, and all admissions to our department (or any department in the same region) due to sepsis within two weeks of the procedure were registered.

RESULTS: A total of 438 patients had the procedure performed, some multiple times, which resulted in a total of 511 procedures. In all, four patients were later admitted due to sepsis, corresponding to 0.91%. Three of the patients had positive blood and urine cultures in which Escherichia coli resistant to ciprofloxacin were found, the last had been prescribed antibiotics by a general practitioner the previous day, and no bacteria could be cultured.

CONCLUSION: The frequency of sepsis after transrectal needle biopsies from the prostate at our department was found to be below 1% in this study, which is comparable to international findings. Most of the cases of sepsis were related to ciprofloxacin resistant bacteria. Further randomised studies are needed to investigate the ideal prophylactic regime.

Written by:
Hayatzaki K, Menne S, Nielsen K.   Are you the author?
Urologisk Afdeling, Næstved Sygehus, Ringstedgade 61, 4700 Næstved, Denmark.  

Reference: Dan Med J. 2014 Nov;61(11):A4963.

PubMed Abstract
PMID: 25370963 Prostate Cancer Section