Abstract
ABSTRACTPurpose:To determine the risk factors and the efficiency of rectal swab samples to prevent infectious complications in prostate biopsy, and compare fosfomycin with ciprofloxacin use in prophylaxis.Materials and Methods:Between May and October 2014, pre-biopsy risk factors and their effect in ciprofloxacin and fosfomycin prophylaxis were determined. Pre-biopsy urinalysis, urine culture and rectal swab samples were obtained from all of the patients. Rectal swabs were obtained upon admission, and biopsy was performed in the following 3-7 days. The place of rectal swab samples and efficiency of fosfomycin use was evaluated.Results:Pre-biopsy rectal swabs were obtained from 110 patients who revealed 60.9% fluoroquinolone resistance (FQR), and 32.7% fluoroquinolone sensitivity (FQS). Fosfomycin resistance was present in 3 patients. Ciprofloxacin use in last 6 months was the only risk factor for FQR. Antibiotic prophylaxis was given to both groups with and without risk factors, according to swab results, and no infective complications were observed. Among the group where fosfomycin was used empirically, one patient had an infection needing hospitalization, however this constitutes no statistical difference between the Group that fosfomycin used empirically or according to swab results (p=0.164).Conclusions:In prostate biopsy prophylaxis, ciprofloxacin may be used liberally in patients without risk factors, but it should be given according to the rectal swab results in the patients with risk, and fosfomycin may be used independently of risk factors and rectal swab results.
Highlights
Prostate cancer (PCa) is an important disease because of its high incidence and being the second cancer mortality cause [1]
Up to 20% increase in the fluoroquinoibju | fosfomycin for prostate biopsy prophylaxis lone resistance (FQR) in rectal swab samples and the observation of the fluoroquinolone resistance (FQR) bacteria in about 50% of the infections have created a need for alternative prophylaxis [3]
When we examined the 30 patients in the Groups B1, B2, and B3, all with risk factors, we found that 56.7% (n=17) with FQR and 34.3%
Summary
Prostate cancer (PCa) is an important disease because of its high incidence and being the second cancer mortality cause [1]. Infection is the most serious complication of biopsy It is mostly afebrile, non-complicated (1.2-11.3%), but rarely it can become pyretic (1.4-4.5%), may cause severe sepsis (0.3-3%), needing hospitalization and lead to a life threatening condition [2]. Up to 20% increase in the fluoroquinoibju | fosfomycin for prostate biopsy prophylaxis lone resistance (FQR) in rectal swab samples and the observation of the FQR bacteria in about 50% of the infections have created a need for alternative prophylaxis [3]. For TRUSG-Bx prophylaxis, fosfomycin may be preferred, because it’s more reliable than the fluoroquinolones. It has lower resistance rate and oral single-dose usage [4]
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