MP16-01 INCREASED RISK OF BLEEDING AT PROCEDURE WITH INTRAVENOUS CEFTRIAXONE PROPHYLAXIS FOR TRANSRECTAL ULTRASOUND GUIDED PROSTATE BIOPSY

Abstract

You have accessJournal of UrologyInfections/Inflammation of the Genitourinary Tract: Prostate & Genitalia1 Apr 2014MP16-01 INCREASED RISK OF BLEEDING AT PROCEDURE WITH INTRAVENOUS CEFTRIAXONE PROPHYLAXIS FOR TRANSRECTAL ULTRASOUND GUIDED PROSTATE BIOPSY Annika Krystyna, Minakshi Ramchand, Robert Tenney, Tarang Safi, William Matthew Briggs, and Murray David Schwalb Annika KrystynaAnnika Krystyna More articles by this author , Minakshi RamchandMinakshi Ramchand More articles by this author , Robert TenneyRobert Tenney More articles by this author , Tarang SafiTarang Safi More articles by this author , William Matthew BriggsWilliam Matthew Briggs More articles by this author , and Murray David SchwalbMurray David Schwalb More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.574AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Preliminary analysis of 438 men receiving intravenous (IV) ceftriaxone prophylaxis prior to transrectal ultrasound guided prostate biopsy (TRPB) was conducted in an effort to reduce our institutions observed rate of infectious complications with oral ciprofloxacin only. METHODS Men who had TRPB between October 19, 2009 and October 31, 2013 and received 1 or 2 grams of IV ceftriaxone were followed for thirty days after biopsy for complications. Rates were compared to observed complications with oral ciprofloxacin use from January 1, 2007 until October 18, 2009 using the Chi-squared test. The study was approved by the Institutional Review Board. RESULTS Refer to Table 1. CONCLUSIONS Intravenous ceftriaxone prophylaxis prior to TRPB was effective at reducing total infectious complications in our population. There was an increased risk of bleeding at the time of biopsy. Complications were treated clinically with rectal packing and no men required blood transfusion. The mechanism of bleeding via hypoprothrombinemia with IV ceftriaxone use is described by the manufacturer. This is the only trial describing bleeding associated with IV ceftriaxone use prior to TRPB. Table 1. Comparison of IV ceftriaxone and oral ciprofloxacin complications. Complication IV Ceftriaxone Oral Ciprofloxacin P value Bacteremia 0.3% 1.0% 0.4 Febrile UTI 0.3% 2.7% 0.008 Fever 0.5% 4.4% <0.0001 Dysuria 0.3% 2.0% 0.04 Urinary retention 3.0% 3.0% 1.0 Rectal packing at procedure for bleeding 3.6% 0.0% 0.001 Hematospermia 2.1% 0.7% 0.2 Hematuria 4.4% 4.5% 1.0 © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e153 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Annika Krystyna More articles by this author Minakshi Ramchand More articles by this author Robert Tenney More articles by this author Tarang Safi More articles by this author William Matthew Briggs More articles by this author Murray David Schwalb More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...