Single Dose of Levofloxacin versus Three Dosages for Prophylaxis in Prostate Biopsy.

Edgar Linden-Castro,Marcela Pelayo-Nieto,Fernando Carreño-De La Rosa,Alejandro Alias-Melgar

doi:10.1155/2014/875670

Abstract

Transrectal ultrasound-guided core prostate biopsy is a key event in the diagnosis of prostate cancer, transient side events such as local pain, haematuria, haematospermia, dysuria, and rectal bleeding are reported in a large number of patients. Antimicrobial agents lower the incidence of postbiopsy infectious complications. The timing and duration of the regimen and the route of administration remain controversial. We developed a standard prophylactic regimen, in which safety and efficiency were maximized, while costs and variability were minimized. Accordingly we prospectively evaluated 425 consecutive patients, who underwent outpatient transrectal ultrasound-guided prostate biopsy after a single dose versus three doses of levofloxacin.

Highlights

Prostate biopsy guided by transrectal ultrasound is a key element in the diagnosis of prostate cancer, but its implementation lacks in terms of safety and complications [1]
In the present study we evaluate and compare the efficacy of single dose of 500 mg of levofloxacin orally administered at the day of the procedure versus three doses of the same drug for prophylaxis in patients undergoing transrectal prostate biopsy guided by ultrasound
We evaluated 615 patients with standard indication for prostate biopsy guided by transrectal ultrasound (elevation of prostate specific antigen (PSA), abnormal digital rectal examination)

Summary

Introduction

Prostate biopsy guided by transrectal ultrasound is a key element in the diagnosis of prostate cancer, but its implementation lacks in terms of safety and complications [1]. Despite performing more than one million prostate biopsies in the United States and Europe each year and clinical guidelines exist, there is no consensus on the regime of antimicrobial prophylaxis in clinical practice. Most studies use schemes ranging from prophylaxis use previous hours, to the use of antimicrobials 1–3 days before the procedure [11]. In the present study we evaluate and compare the efficacy of single dose of 500 mg of levofloxacin orally administered at the day of the procedure versus three doses of the same drug for prophylaxis in patients undergoing transrectal prostate biopsy guided by ultrasound

Methods

Findings

Discussion

Conclusion