Premium
One preoperative dose randomized against 3‐day antibiotic prophylaxis for transrectal ultrasonography‐guided prostate biopsy
Author(s) -
Briffaux Raphaël,
Coloby Patrick,
Bruyere Franck,
Ouaki Frédéric,
Pires Christophe,
Doré Bertrand,
Irani Jacques
Publication year - 2009
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2008.08128.x
Subject(s) - medicine , bacteriuria , randomized controlled trial , prostate biopsy , antibiotic prophylaxis , biopsy , transrectal ultrasonography , ciprofloxacin , surgery , prostatitis , urology , antibiotics , asymptomatic , prostate , urine , cancer , microbiology and biotechnology , biology
OBJECTIVE To compare the incidence of infective events between a single dose and 3‐day antibiotic prophylaxis for transrectal ultrasonography (TRUS)‐guided prostate biopsy. PATIENTS AND METHODS Patients were randomized to receive either one preoperative dose consisting of two ciprofloxacin 500 mg tablets 2 h before prostate biopsy, or 3 days of ciprofloxacin treatment. They had a clinical examination at study inclusion, the day of the biopsy and 3 weeks later. The day after the procedure all patients were contacted by telephone to inquire about any significant event. Biological testing and urine cultures were conducted 5 days before and then 5 and 15 days after the biopsy; a self‐administered symptom questionnaire was completed by the patient 5 days before and then at 5 and 15 days. RESULTS The study group included 288 men, of whom 139 were randomized to the single‐dose arm and 149 to the 3‐day arm. Six patients in each group had an asymptomatic bacteriuria with no leukocyturia. One patient in each group had documented prostatitis, with Escherichia coli identified on urine culture. The strain identified in the patient from the 3‐day group was resistant to ciprofloxacin. There was no difference between groups in symptoms at 5 and 21 days after biopsy. CONCLUSIONS Current TRUS‐guided prostate biopsy techniques lead to very few clinical infectious complications when accompanied by antibiotic prophylaxis. We found no argument to advocate the use of more than one dose of antibiotic prophylaxis.