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01-12-2015 | Original Article

An antimicrobial prophylaxis protocol using rectal swab cultures for transrectal prostate biopsy

Authors: Stephen J. Summers, Darshan P. Patel, Blake D. Hamilton, Angela P. Presson, Mark A. Fisher, William T. Lowrance, Andrew W. Southwick

Published in: World Journal of Urology | Issue 12/2015

Abstract

Purpose

To evaluate the benefit of an antimicrobial prophylaxis protocol using rectal swab cultures in patients undergoing transrectal ultrasound (TRUS)-guided prostate biopsy in our Veterans Affairs population.

Methods

Between June 1, 2013, and June 1, 2014, we implemented an antimicrobial prophylaxis protocol using rectal swab cultures on selective media containing ciprofloxacin for all men scheduled for TRUS-guided prostate biopsy. Data from 2759 patients from Jan 1, 2006 to May 31, 2013, before protocol implementation served as historical controls. Patients with fluoroquinolone (FQ)-susceptible organisms received FQ monotherapy, while those with FQ-resistant organisms received targeted prophylaxis. Our objective was to compare the rate of infectious complications 30 days after prostate biopsy before and after implementation of our antimicrobial protocol.

Results

One hundred and sixty-seven patients received rectal swab cultures using our protocol. Seventeen (14 %) patients had FQ-resistant positive cultures. Patients with positive FQ-resistant culture results were more likely to have had a history of previous prostate biopsy and a positive urine culture in the last 12 months (p = 0.032, p = 0.018, respectively). The average annual infectious complication rate within 30 days of biopsy was reduced from 2.8 to 0.6 % before and after implementation of our antimicrobial prophylaxis protocol using rectal swab cultures, although this difference was not statistically significant (p = 0.13).

Conclusion

An antimicrobial prophylaxis protocol using rectal culture swabs is a viable option for prevention of TRUS-guided prostate biopsy infectious complications. After implementation of an antimicrobial prophylaxis protocol, we observed a nonsignificant decrease in the rate of post-biopsy infectious complications when compared to historical controls.

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Title: An antimicrobial prophylaxis protocol using rectal swab cultures for transrectal prostate biopsy
Authors: Stephen J. Summers
Darshan P. Patel
Blake D. Hamilton
Angela P. Presson
Mark A. Fisher
William T. Lowrance
Andrew W. Southwick
Publication date: 01-12-2015
Publisher: Springer Berlin Heidelberg
Published in: World Journal of Urology / Issue 12/2015
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-015-1571-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

An antimicrobial prophylaxis protocol using rectal swab cultures for transrectal prostate biopsy

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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