MP82-12 COMBINATION OF A CEPHALOSPORIN/FLUOROQUINOLONE ANTIBIOTIC REGIMEN AND ISOPROPYL ALCOHOL NEEDLE WASHING IS SIGNIFICANTLY ASSOCIATED WITH REDUCED RISK OF SEPSIS AFTER PROSTATE BIOPSY

Abstract

You have accessJournal of UrologyProstate Cancer: Detection & Screening VII1 Apr 2018MP82-12 COMBINATION OF A CEPHALOSPORIN/FLUOROQUINOLONE ANTIBIOTIC REGIMEN AND ISOPROPYL ALCOHOL NEEDLE WASHING IS SIGNIFICANTLY ASSOCIATED WITH REDUCED RISK OF SEPSIS AFTER PROSTATE BIOPSY Matthew Simmons, Andrew Neeb, and Marta Johnson-Mitchell Matthew SimmonsMatthew Simmons More articles by this author , Andrew NeebAndrew Neeb More articles by this author , and Marta Johnson-MitchellMarta Johnson-Mitchell More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.2740AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Sepsis after prostate biopsy is a severe and potentially life-threatening complication. This has been reported at 2-6% in various series. This study analyzed the impact of 3 different prophylactic regimens on post-biopsy sepsis incidence. METHODS Data was reviewed for 824 patients who underwent prostate biopsy in a community practice clinic between January 2013 and October 2017. Sepsis was defined as development of fever, chills, leukocystosis and/or hemodynamic instability requiring hospital admission for supportive care and IV antibiotic treatment. The study was conducted in sequential patients. Group 1 (n=313) consisted of patients who underwent biopsy between 1/2013 and 4/2017. These patients received ciprofloxacin 500mg PO BID for 4 days starting the day prior to biopsy and gentamicin 80mg IM 20 minutes prior to biopsy. From 4/2015 to 10/2017 two groups of patients were followed in parallel in a randomized manner. Group 2 (n=252) received ciprofloxacin 500mg PO BID for 4 days starting the day prior to biopsy and Rocephin 1g IM 20 minutes prior to biopsy. Group 3 (n=259) received the same antibiotic regimen as group 2, but also had isopropyl needle washing. Needle washing involved firing the biopsy needle into 70% isopropyl alcohol followed by a quick dip in saline between each biopsy. RESULTS Incidence of post-biopsy sepsis in Group 1 was 3.8%. Incidence of sepsis in group 2 was 1.5%. Incidence of post-biopsy sepsis in Group 3 was 0%. One-way ANOVA analysis showed an F value of 5.6 and a p value of 0.003. Differences in sepsis incidence between treatments were statistically significant. CONCLUSIONS In our practice we saw a significant reduction in the sepsis complications after prostate biopsy using a combination of a Rocephin/Cipro antibiotic regimen and isopropyl alcohol needle washing. The technique for needle washing is inexpensive and quick and can be easily adopted into current biopsy protocols. Reproduction of these results in other centers are needed to validate these findings. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e1111 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Matthew Simmons More articles by this author Andrew Neeb More articles by this author Marta Johnson-Mitchell More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...