Abstract
An increase in the rate of complications after prostate biopsy (PB) due to increased antibiotic-resistant bacteria is a global issue. We report the safety of aztreonam as a prophylactic antibiotic in patients undergoing PB. We investigated the complication rates according to several antibiotic regimens, including aztreonam. We hypothesized that PB complications increased following a rise in antibiotic-resistant bacteria. We examined the annual rates of complications among patients in our hospital (clinical cohort) and the Korea Health Insurance Review and Assessment Service (HIRA) cohort. Data regarding complications, hospitalization, emergency room (ER) visits, and febrile urinary tract infections occurring within 2 weeks after PB were recorded. The rate of complications was significantly lower in patients who received oral quinolone and intravenous aztreonam than in those who received oral quinolone. The complication rates did not increase throughout the study period. Additionally, 1754 patients from the HIRA cohort were included. The rates of complications, hospitalizations, and ER visits did not increase among these patients. Oral quinolone combined with intravenous aztreonam reduced the rate of febrile complications compared to quinolone alone and was safe to use after PB. Therefore, we recommend intravenous aztreonam with oral quinolone as a prophylactic antibiotic regimen before PB.
Highlights
Prostate cancer is the fifth most common cancer and has the second-fastest increase in prevalence in men, according to the Korean National Statistical Centre [1]
We investigated whether complications of prostate biopsy (PB) increase with time using data from the Korea Health Insurance Review and Assessment Service (HIRA) cohort and clinical data from PB performed at our institution
This study consisted of two datasets: clinical data obtained from patients who underwent PB at our institution and data from patients in the HIRA cohort
Summary
Prostate cancer is the fifth most common cancer and has the second-fastest increase in prevalence in men, according to the Korean National Statistical Centre [1]. Transrectal ultrasonography-guided prostate biopsy (PB) is the gold standard method for collecting prostate tissue to diagnose prostate cancer. PB is a safe procedure performed in an outpatient setting, post-procedural complications include urinary tract infection, hematuria, hemospermia, and urinary obstruction. Rare, uncontrolled febrile urinary tract infection may progress to sepsis as a severe condition [2]. The number of patients requiring a PB is increasing worldwide, as the prostate-specific antigen (PSA) is being used as a standard to screen for prostate cancer. PB is a safe procedure, the number of patients requiring hospitalization due to complications has increased in several regions over the past 10 years. It can be correlated to the increase in the number of antibiotic-resistant bacteria [3,4]. In addition to increasing the frequency of infection-related complications by
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