Role of rectal swab culture in prevention of infectious complications following transrectal ultrasound guided prostate biopsy
Keywords:
Antibiotic prophylaxis, prostate, biopsy, luoroquinolones, drug resistance, rectal swabAbstract
Objective: To evaluate the efficacy of targeted antimicrobial prophylaxis in decreasing infectious complications in men who underwent transrectal ultrasound guided prostate biopsy based on rectal swab culture results.
Material and Method: Between July 2016 and September 2018 we compared the incidence of infectious complications in men who received a targeted versus a standard empirical prophylaxis antibiotic before undergoing a transrectal ultrasound guided prostate biopsy. The targeted prophylaxis antibiotic was selected from the cultures of the rectal swab plated on selective media containing ciprofloxacin
to identify fluoroquinolone resistant bacteria. We identified men with infectious complications within 14 days after standard transrectal ultrasound guided prostate biopsy.
Result: Sixty-two patients received targeted antimicrobial prophylaxis based on the outcome of the rectal swab culture while a comparison group of 62 patients received empirical FQ prophylaxis. Fifty out of the 62 (80.6%) men in the targeted antibiotic group harbored FQ resistant organisms. Four (6.4%) had infectious complications, but at just a low level (fever, UTI). In contrast, 7 (12%) of the 62 men who received FQ prophylaxis had infectious complications, 2 of whom (4%) had sepsis. There was no statistically significant difference in infection rate between the groups.
Conclusion: Targeted antimicrobial prophylaxis based on the findings of a rectal swab culture had a tendency to decrease post TRUSBx infectious complications, but the differences were not statistically significant.
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