962 Are We Right to Continue to Omit Antibiotic Prophylaxis in Trans-Perineal Prostate Biopsies? A Clinical Audit in a Single NHS Trust

Abstract

Abstract Introduction Transperineal Prostate Biopsies (TPPB) offer lower rates of infection-related complications than Transrectal Prostate Biopsies (TRPB), with post-procedural sepsis rates reported between 0.5% and 3%. The intuitive evolution from TRPB to TPPB has, however, involved the use of routine antibiotic prophylaxis, but studies have shown that there may be no difference in infection rates post procedure in patients with and without antibiotics. Aim This audit aimed to assess infection-related complications in patients undergoing TPPB without antibiotic prophylaxis in a single NHS Trust, following the Trust decision to discontinue antibiotic use. Method Retrospective analysis of 200 patients that had been biopsied between April 2022 and October 2022 was performed. 28-day post procedure hospitalisation and sepsis rates were assessed, in addition to 28-day GP presentations, antibiotic prescriptions and relevant co-morbidities. Results The cohort had a mean age of 70.1 years. The most common co-morbidities included Hypertension and Type 2 Diabetes Mellitus. 1 patient presented to hospital with sepsis within 28 days, representing a post-procedure infection rate of 0.5%. This patient received IV antibiotics in hospital and was discharged after 3 days. No patients presented to their GP within 28 days post procedure or were prescribed antibiotics in the community. Conclusions Given the low post procedure infection rates, we believe the evidence provided in this audit further supports and justifies the discontinuation of routine prophylactic antibiotics in patients undergoing TPPB. We believe this to be relevant in a world where antibiotic stewardship is becoming an ever more important issue.