Single-Dose Versus Multiple-Dose Ciprofloxacin Plus Metronidazole Prophylaxis in Transrectal Ultrasound-Guided Biopsy of the Prostate: a Randomized Controlled Trial
-
Zhoobin Heidari Bateni
,
Hossein Shahrokh
,
Hormoz Salimi
,
Hossein Safari
,
Meghdad Tabatabai
,
Dariush Saedi
Abstract
To investigate and compare the infectious and non-infectious complications of single-dose versus multiple-dose antibiotic therapy for trans-rectal ultrasound (TRUS)-guided biopsy of the prostate. Patients were enrolled in a prospective randomized study that was designed to investigate the effects of single-dose versus multiple-dose antimicrobial prophylaxis regimen mainly on asymptomatic bacteriuria, urinary tract infection (UTI) without fever, fever and urinary septicemia. The single-dose group received one ciprofloxacin 500 mg tablet and two metronidazole 250 mg tablets at 2 hours before the biopsy, while the multiple-doses group received those every 12 hours from 3 days before the biopsy. One-hundred and sixty patients were evaluated in two groups and bacteriuria in urinalysis was encountered in 12 patients (15%) in the single-dose group and four patients (5%) in the multiple-dose group, with a significant difference (P=0.035). UTI without fever occurred in six patients (7.5%) in the single-dose group and one patient (1.25%) in the multiple-dose group, with no significant difference (borderline P=0.053). After biopsy, three patients (3.75%) returned with fever due to UTI and bacteremia in the single-dose group and none in the multiple-dose group, but with no significant difference (P=0.08). Regarding non-infectious complications, there were no significant differences between the two groups. Using prophylactic antibiotics for prostate biopsy in multiple doses, and at least 3 days before the procedure significantly reduces the rate of bacteriuria compared with a single-dose regimen.
Rodriguez LV, Terris MK. Risks and complications of transrectal ultrasound guided biopsy or prostate needle biopsy: a prospective study and review of the literature. J Urol 1998;160(6 Pt 1):2115-20.
Djavan B, Waldert M, Zlotta A, et al. Safety and morbidity of first and repeat transrectal ultrasound guided biopsy or prostate needle biopsies: results of a prospective European Prostate Cancer Detection Study. J Urol 2001;166(3):856-60.
Aron M, Rajeev TP, Gupta NP. Antibiotic prophylaxis for transrectal needle biopsy of the prostate: a randomized controlled study. BJU Int 2000;85(6):682-5.
Sieber PR, Rommel FM, Agusta VE, et al. Antibiotic prophylaxis in ultrasound guided transrectal prostate biopsy. J Urol 1997;157(6):2199-200.
Kapoor DA, Klimberg IW, Malek GH, et al. Single-dose oral ciprofloxacin versus placebo for prophylaxis during transrectal prostate biopsy. Urology 1998;52(4):552-8.
Bootsma AM, Laguna Pes MP, Geerling SE, et al. Antibiotic prophylaxis in urologic procedures. A systematic review. Euro Urol 2008;54(6):1270-86.
Sabbagh R, McCormack M, Peloquin F, et al. A prospective randomized trial of 1-day versus 3-day antimicrobial prophylaxis for transrectal ultrasound guided prostate biopsy. Can J Urol 2004;11(2):2216-9
Briffaux R, Coloby P, Bruyere F, et al. One preoperative dose randomized against 3-day antibiotic prophylaxis for transrectal ultrasonography-guided prostate biopsy. BJU Int 2009;103(8):1069-73.
Webb NR, Woo HH. Antibiotic prophylaxis for prostate biopsy. BJU Int 2002;89(8):824-8.
Davis M, Sofer M, Kim SS, et al. The procedure of transrectal ultrasound guided transrectal prostate biopsy: a survey of patient preparation and biopsy technique. J Urol 2002;167(2 Pt 1):566-70.
Janoff DM, Skarecky DW, McLaren CE, et al. Prostate needle biopsy infection after four or six dose ciprofloxacin. Can J Urol 2000;7(4):1066-9.
Aus G, Ahlgren G, Bergdahl S, et al. Infection after transrectal core biopsies of the prostate- risk factors and antibiotic prophylaxis. Br J Urol 1996;77(6):851-5.
Shaeffer AJ, Montorsi F, Scattoni V, et al. Comparison of a 3-day with a 1-day regimen of an extended release formulation of ciprofloxacin as antimicrobial prophylaxis for patients undergoing transrectal needle biopsy of the prostate. BJU Int 2007;100(1):51-7.
Brewster SF, Rooney N, Kabala J, et al. Fatal anaerobic infection following transrectal biopsy of a rare prostatic tumour. Br J Urol 1993;72(6):977-8.
Breslin JA, Turner BI, Faber RB, et al. Anaerobic infection as a consequence of transrectal prostatic biopsy. J Urol 1978;120(4):502-3.
McArdle CS, Moran CG, Pettit L, et al. Value of oral antibiotic prophylaxis in colorectal surgery. Br J Surg 1995;82(8):1046-8.
Shandra KC, Thibault GP, Deshon GE Jr. Variability in patient preparation for prostate biopsy among American urologists. Urology 1998;52(4):644-6.
Crawford ED, Haynes AL Jr, Story MW, et al. Prevention of urinary tract infection and sepsis following transrectal prostate biopsy. J Urol 1982;127(3):449-51
Griffith BC, Morey AF, Ali-Khan MM, et al. Single dose levofloxacin prophylaxis for prostate biopsy in patients at low risk. J Urol 2002;168(3):1021-3.
Shigemura K, Tanaka K, Yasuda M, et al. Efficacy of 1- day prophylaxis medication with fluoroquinolone for prostate biopsy. World J Urol 2005;23(5):356-60.
Cam K, Kayikci A, Akman Y, et al. Prospective assessment of the efficacy of single dose versus traditional 3-day antimicrobial prophylaxis in 12-core transrectal prostate biopsy. Int J Urol 2008;15(11):997-1001.
Lugg J, Lettieri J, Stass H, et al. Determination of the concentration of ciprofloxacin in prostate tissue following administration of a single, 1000 mg, extended-release dose. J Chemother 2008;20(2):213-8.
Lindstedt S, Lindström U, Ljunggren E, et al. Single-dose antibiotic prophylaxis in core prostate biopsy: Impact of timing and identification of risk factors. Eur Urol 2006;50(4):832-7.
Naber KG, Sörgel F. Antibiotic therapy--rationale and evidence for optimal drug concentrations in prostatic and seminal fluid and in prostatic tissue. Andrologia 2003;35(5):331-5.
Gouliouris T, Brown NM, Aliyu SH. Prevention and treatment of Clostridium difficile infection. Clin Med 2011;11(1):75-9.
Deshpande A, Pant C, Jain A, et al. Do fluoroquinolones predispose patients to Clostridium difficile associated disease? A review of the evidence. Curr Med Res Opin 2008;24(2):329-33.
Zani EL, Clark OA, Rodrigues Netto N Jr. Antibiotic prophylaxis for transrectal prostate biopsy. Cochrane Database Syst Rev 2011;11(5):CD006576.
Petteffi L, Toniazzo GP, Sander GB, et al. Efficiency of short and long term antimicrobial therapy in transrectal ultrasound-guided prostate biopsies. Int Braz J Urol 2002;28(6):526-32.
Ekici S, Cengiz M, Turan G, et al. Fluoroquinoloneresistant acute prostatitis requiring hospitalization after transrectal prostate biopsy: effect of previous fluoroquinolone use as prophylaxis or long-term treatment. Int Urol Nephrol 2012;44(1):19-27.
| Files | ||
| Issue | Vol 52, No 9 (2014) | |
| Section | Original Article(s) | |
| Keywords | ||
| Transrectal Ultrasonographic Biopsy of Prostate Antibiotic Prophylaxis Prostate cancer | ||
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