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

Abstract

Abstract Background There 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. Results The 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. Conclusions The 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.

Keywords

• Prostate
• Biopsy
• Transrectal ultrasound
• Sepsis
• Antibiotic prophylaxis