| Changing antibiotic prophylaxis for transrectal ultrasound-guided prostate biopsies: are we putting our patients at risk? | |
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MedLine Citation:
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PMID: 20518764 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To evaluate whether changing antibiotic prophylaxis from quinolone to penicillin antibiotics has affected infectious complication rates in those men undergoing transrectal ultrasound-guided prostate biopsy (TRUSgpb). PATIENTS AND METHODS: This interventional study was designed to determine whether changing antibiotic prophylaxis had any bearing on developing serious infectious complications after taking TRUSgpb. As a secondary aim, we also investigated Clostridium difficile (C. difficile) rates in the same groups of men undergoing TRUSgpb. Men historically received ciprofloxacin 500 mg orally 1 h before their procedure followed by a 3-day course of 500 mg given twice daily (group A). Due to increasing local patterns of antimicrobial resistance to quinolones and concerns regarding potential antibiotic induced C. difficile infection, antibiotic prophylaxis was changed to a penicillin-based regimen comprising of co-amoxiclav 625 mg given orally 1 h before TRUSgpb followed by a three times daily course for 3 days (group B). Excluded from the study were those men given an alternative antibiotic prophylaxis than those given within the two distinct groups due to reasons of previous hypersensitivity reactions and/or clinical decision by the attending Urologist. Comparisons were made between the groups using two-tailed Fisher's exact tests. RESULTS: In all, 119 and 110 men were identified in groups A and B, respectively. Two men in group A (1.68%) developed sepsis after TRUSgpb requiring hospital admission and intravenous antibiotic treatment. The sepsis rate in group B was significantly higher than that of group A (eight of 110, 7.27%; P = 0.036). Escherichia coli was the only organism isolated from our cohort of patients. There were no incidences of C. difficile infections in either antibiotic prophylaxis groups. CONCLUSION: Ciprofloxacin appears to provide superior prophylaxis than co-amoxiclav in men undergoing TRUSgpb and was not associated with an increased risk of quinolone induced C. difficile infections. Changing antibiotic prophylaxis from a quinolone-based regime may therefore be putting our patients at an increased risk of serious infectious complications after TRUSgpb. |
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Authors:
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Satoshi Hori; Anup Sengupta; Alexis Joannides; Ben Balogun-Ojuri; Rebecca Tilley; John McLoughlin |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: BJU international Volume: 106 ISSN: 1464-410X ISO Abbreviation: BJU Int. Publication Date: 2010 Nov |
Date Detail:
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Created Date: 2010-10-15 Completed Date: 2010-11-22 Revised Date: 2011-09-12 |
Medline Journal Info:
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Nlm Unique ID: 100886721 Medline TA: BJU Int Country: England |
Other Details:
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Languages: eng Pagination: 1298-302; discussion 1302 Citation Subset: IM |
Copyright Information:
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© 2010 THE AUTHORS. JOURNAL COMPILATION © 2010 BJU INTERNATIONAL. |
Affiliation:
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Department of Urology, West Suffolk Hospital, Bury St. Edmunds, UK. satoshi@doctors.org.uk |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Amoxicillin-Potassium Clavulanate Combination / therapeutic use Anti-Infective Agents / therapeutic use* Antibiotic Prophylaxis* Biopsy / adverse effects*, methods Ciprofloxacin / therapeutic use Epidemiologic Methods Humans Male Middle Aged Penicillins / therapeutic use Prostate / pathology Prostatic Neoplasms / pathology* Rectum / microbiology Treatment Outcome Ultrasonography, Interventional |
| Chemical | |
Reg. No./Substance:
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0/Anti-Infective Agents; 0/Penicillins; 74469-00-4/Amoxicillin-Potassium Clavulanate Combination; 85721-33-1/Ciprofloxacin |
| Comments/Corrections | |
Comment In:
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BJU Int. 2011 Aug;108(4):E155
[PMID:
21794057
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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