MADRID, SPAIN (UroToday.com) - With fluoroquinolone resistance on the rise, the use of rectal swabs pre-biopsy may help to identify patients harboring fluoroquinolone-resistant bacteria who would benefit from usage of an alternative prophylactic antibiotic regimen. In this study the authors describe their experience with this technique and compared the outcomes to patients who received empirical antibiotic therapy in years preceding.
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In total, the study included 145 patients who received targeted antibiotic prophylaxis and 155 patients who received empirical antibiotic prophylaxis prior to undergoing a transrectal prostate biopsy. The authors found that 16% of the targeted prophylaxis cohort was found to have fluoroquinolone resistant bacteria. Bacteria from these patients underwent antibiotic susceptibility testing to determine which alternate prophylactic antibiotic would ultimately used. Only one patient (0.7%) in the targeted prophylaxis group developed an infectious complication from biopsy (a UTI). In contrast, 16% of empirical prophylaxis patients experienced an infectious complication, including 2 who became septic. This difference was statistically significant, and, per the authors, resulted in a total estimated savings of over $50,000 with targeted prophylaxis compared to empirical prophylaxis. Based on these results, the authors estimated that 6 men would need to undergo rectal swab testing prior to biopsy to prevent one infectious complication. The authors concluded that further prospective evaluation of rectal swab use was necessary to validate their findings.
Presented by Baldissera Aradas JV, Rodriguez Villamil L, Blanco Fernandez R, Perez Garcia C, Diaz Mendez B, Viejo G, Gil Ugarteburu R, Gonzalez Rodriguez I, and Cuervo Calvo J at the 30th Annual European Association of Urology (EAU) Congress - March 20 - 24, 2015 - IFEMA - Feria de Madrid - Madrid, Spain
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Reported by Timothy Ito, MD, medical writer for UroToday.com