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01-01-2020 | Ciprofloxacin | Topic Paper

Antibiotic resistance, hospitalizations, and mortality related to prostate biopsy: first report from the Norwegian Patient Registry

Authors: Truls E. Bjerklund Johansen, Per-Henrik Zahl, Eduard Baco, Riccardo Bartoletti, Gernot Bonkat, Franck Bruyere, Tommaso Cai, Mete Cek, Ekaterina Kulchavenya, Bela Köves, Vladimir Mouraviev, Adrian Pilatz, Zafer Tandogdu, Peter Tenke, Florian M. E. Wagenlehner

Published in: World Journal of Urology | Issue 1/2020

Abstract

Background

A 68-year-old man died of cerebral arterial embolism 6 days after transrectal prostate biopsy with a single p.o. dose of trimethoprim sulfamethoxazole (TMP-SMX) as prophylaxis. The case precipitated analysis of local antibiotic resistance and complication rates.

Materials and methods

Data on E. coli resistance from Oslo University Hospital and national data on hospitalizations and mortality after biopsy were retrieved from local microbiology files and the Norwegian Patient Registry (NPR) 2011–2017.

Results

Urine E. coli resistance against TMP-SMX increased from 35% in 2013 to more than 60% in 2015. For ciprofloxacin, the resistance increased from 15% in 2013 to about 45% in 2016. The highest annual E. coli resistance in blood cultures for TMP-SMX and ciprofloxacin was 37% and 28%, respectively. 10% of patients were hospitalized with a diagnosis of infection within the first 60 days after biopsy and there was a relative increase in mortality rate of 261% within the first 30 days. Due to the severity of the figures, the story and the NPR data were published in Norway’s leading newspaper and were succeeded by a series of chronicles and commentaries.

Conclusions

Several critical points of the biopsy procedure were not performed according to current standards. We believe that the patient might have died of septic embolism after biopsy. As a result of the findings and the debate, local practice was changed from transrectal to transperineal prostate biopsies.

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Title: Antibiotic resistance, hospitalizations, and mortality related to prostate biopsy: first report from the Norwegian Patient Registry
Authors: Truls E. Bjerklund Johansen
Per-Henrik Zahl
Eduard Baco
Riccardo Bartoletti
Gernot Bonkat
Franck Bruyere
Tommaso Cai
Mete Cek
Ekaterina Kulchavenya
Bela Köves
Vladimir Mouraviev
Adrian Pilatz
Zafer Tandogdu
Peter Tenke
Florian M. E. Wagenlehner
Publication date: 01-01-2020
Publisher: Springer Berlin Heidelberg
Keywords: Ciprofloxacin
Antibiotic
Published in: World Journal of Urology / Issue 1/2020
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-019-02837-0

At a glance: The STEP trials

Springer Medicine

Antibiotic resistance, hospitalizations, and mortality related to prostate biopsy: first report from the Norwegian Patient Registry

Abstract

Background

Materials and methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Materials and methods

Results

Conclusions

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