MP09-01 THE ROLE OF PROPHYLACTIC ANTIBIOTICS IN TRANSPERINEAL PROSTATE BIOPSY: A SYSTEMATIC REVIEW AND METANALYSIS

Abstract

You have accessJournal of UrologyCME1 May 2022MP09-01 THE ROLE OF PROPHYLACTIC ANTIBIOTICS IN TRANSPERINEAL PROSTATE BIOPSY: A SYSTEMATIC REVIEW AND METANALYSIS Spyridon Basourakos, Mark Alshak, Patrick Lewicki, Emily Cheng, Michael Tzeng, Antonio DeRosa, Matthew Allaway, Ashley Ross, Edward Schaeffer, Hiten Patel, Jim Hu, and Michael Gorin Spyridon BasourakosSpyridon Basourakos More articles by this author , Mark AlshakMark Alshak More articles by this author , Patrick LewickiPatrick Lewicki More articles by this author , Emily ChengEmily Cheng More articles by this author , Michael TzengMichael Tzeng More articles by this author , Antonio DeRosaAntonio DeRosa More articles by this author , Matthew AllawayMatthew Allaway More articles by this author , Ashley RossAshley Ross More articles by this author , Edward SchaefferEdward Schaeffer More articles by this author , Hiten PatelHiten Patel More articles by this author , Jim HuJim Hu More articles by this author , and Michael GorinMichael Gorin More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002531.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Transperineal prostate biopsy (TPB) is associated with a significantly lower risk of infectious complications as compared to the transrectal approach. In fact, the risk of infectious complications with TPB is so low that the utility of administering peri-procedure antibiotics with this procedure has come under question. Thus, we performed a systematic review and metanalysis to assess for differences in the rates of infectious complications (septic, non-septic, overall) after TPB performed with and without administration of antibiotic prophylaxis. METHODS: Three electronic databases (PubMed, EMBASE and MEDLINE) were searched, and studies were included if they included men who underwent TPB, were published after January 2000, included information on periprocedural antibiotic administration, and reported post-biopsy complications. Preferred Reporting Items for Systematic Reviews and Metanalyses and Agency for Healthcare Research and Quality guidelines were utilized. RESULTS: A total of 106 unique studies describing 112 cohorts of patients were identified where 98 (37,805 men) received antibiotic prophylaxis and 14 (4,772 men) did not receive antibiotic prophylaxis. All men were included in the analysis of septic complications. In total there were 19 (0.05%) episodes of sepsis in the group of antibiotics. The event rate was similar to the no antibiotic group, in which only 4 (0.08%) patients experienced sepsis (p=0.2). For overall infections (septic plus non-septic), there were 58 (1.22%) events versus 403 (1.35%) among 29,880 men with evaluable data who did and did not receive antibiotic prophylaxis, respectively (p=0.8). Restricting to our analysis to studies with a comparable number of biopsy cores, there remained no difference in the rates of sepsis between groups. In this analysis we also observed a small but statistically significant lower risk of infectious complications with antibiotic administration (0.55 vs. 1.22%, p<0.01). CONCLUSIONS: The likelihood of septic infections after TPB is low with and without antibiotic prophylaxis. The omission of periprocedural antibiotics with this procedure stands to benefit patients by avoiding potential drug reactions. Furthermore, this practice is in line with calls throughout the medical community for improved antibiotic stewardship. Source of Funding: Jim Hu receives research support from the Dow Wallace Fund of the New York Community Trust and salary support from NIH CA241758, PCORI CER-2019C1-15682 and CER-2019C2-17372 © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e135 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Spyridon Basourakos More articles by this author Mark Alshak More articles by this author Patrick Lewicki More articles by this author Emily Cheng More articles by this author Michael Tzeng More articles by this author Antonio DeRosa More articles by this author Matthew Allaway More articles by this author Ashley Ross More articles by this author Edward Schaeffer More articles by this author Hiten Patel More articles by this author Jim Hu More articles by this author Michael Gorin More articles by this author Expand All Advertisement PDF DownloadLoading ...