MP43-14 COMPARISON BETWEEN QUINOLONES AND OTHER ANTIBIOTICS IN PREVENTING INFECTIVE COMPLICATIONS IN TRANSRECTAL PROSTATE BIOPSY

Abstract

You have accessJournal of UrologyProstate Cancer: Detection & Screening IV (MP43)1 Sep 2021MP43-14 COMPARISON BETWEEN QUINOLONES AND OTHER ANTIBIOTICS IN PREVENTING INFECTIVE COMPLICATIONS IN TRANSRECTAL PROSTATE BIOPSY Gabriele Tulone, Vincenzo Serretta, Ettore Dalmasso, Marco Vella, Nino Dispensa, Carlo Pavone, Davide Baiamonte, Piero Mannone, Alberto Abrate, Roberta Aimar, Vincenzo Ficarra, Riccardo Bartoletti, and Alchiede Simonato Gabriele TuloneGabriele Tulone More articles by this author , Vincenzo SerrettaVincenzo Serretta More articles by this author , Ettore DalmassoEttore Dalmasso More articles by this author , Marco VellaMarco Vella More articles by this author , Nino DispensaNino Dispensa More articles by this author , Carlo PavoneCarlo Pavone More articles by this author , Davide BaiamonteDavide Baiamonte More articles by this author , Piero MannonePiero Mannone More articles by this author , Alberto AbrateAlberto Abrate More articles by this author , Roberta AimarRoberta Aimar More articles by this author , Vincenzo FicarraVincenzo Ficarra More articles by this author , Riccardo BartolettiRiccardo Bartoletti More articles by this author , and Alchiede SimonatoAlchiede Simonato More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002064.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Sepsis is one of the most feared complications of prostate biopsy: it’s incidence is 1-3%. Prevention of infection after biopsy procedure consists in prophylactic antibiotic therapy. Quinolones were indicated in European and American guidelines as the first-choice antibiotic prophylaxis up to 2018 European Medicine Agency (EMA) restrictions on their use in patients at risk of aortic aneurysms. Guidelines in prostate biopsies placed quinolones as second-choice antibiotic. The goal of our study was to compare the incidence of infective complications of prostate biopsy adopting different antibiotics. METHODS: A retrospective case-control study including all patients submitted to ultrasound-guided transrectal prostate biopsy before and after the publication of the EMA note (2017 to 2019) was conducted in 3 referral urology institutions (Palermo, Cuneo and Pisa). A standard number of 12 biopsy samples was planned. Biopsy complications (fever, haematuria, haematospermia, rectal bleeding, rectal pain and sepsis) were evaluated in patients undergoing prophylaxis with quinolones (levofloxacin, ciprofloxacin, plurifloxacin), cephalosporins (cefixime, ceftriaxone) and trimethoprim /sulfamethoxazole. The data were compared with the variance analysis (ANOVA). A p value <0.05 was considered significant. RESULTS: Data of 1160 patients were collected. Median age was 70 years (IQR 64-75.6) and median PSA 7.36 ng/ml (IQR 5.38-11). The meadian number of biopsy samples was 12 (range 2-18). Among 448 patients (38.6%) undergoing quinolone prophylaxis, 9.6% reported haematuria, 5.4% haematospermia, 4.2% rectal bleeding and 1.13% fever. Among 606 (52.2%) patients receiving non-quinolone drugs (cephalosporins, trimethoprim /sulfamethoxazole) haematuria was reported in 12.2% patients, haematospermia in 15.4%, rectal bleeding in 9.7% and fever in 3.5%. There was a statistically significant difference in the incidence of the complications described between the two populations examined (p < 0.001 for hematuria, hematospermia and rectal bleeding and p = 0.004 for fever). Incidence was independent from center and operator. CONCLUSIONS: After EMA note in 2018, the European Association Urology guidelines recommended the use of cephalosporins or phosphomycin as the first-choice antibiotic prophylaxis of prostate biopsy in patients at risk of aortic aneurysm. In our study quinolone-based prophylaxis was associated with a lower incidence of complications after prostate biopsy in comparison with other antibiotics. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e787-e787 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Gabriele Tulone More articles by this author Vincenzo Serretta More articles by this author Ettore Dalmasso More articles by this author Marco Vella More articles by this author Nino Dispensa More articles by this author Carlo Pavone More articles by this author Davide Baiamonte More articles by this author Piero Mannone More articles by this author Alberto Abrate More articles by this author Roberta Aimar More articles by this author Vincenzo Ficarra More articles by this author Riccardo Bartoletti More articles by this author Alchiede Simonato More articles by this author Expand All Advertisement Loading ...