Objective
To compare 3 prophylactic regimens to assess their impact on postbiopsy sepsis incidence.
Methods
Data were reviewed for 829 consecutive patients who underwent prostate biopsy in a
community practice setting between January 2013 and October 2017. Group 1 patients
received ciprofloxacin 500 mg two times a day orally for 4 days starting the day prior
to biopsy and gentamicin 80 mg intramuscularly 20 minutes prior to biopsy. From April
2015 to October 2017, 2 groups of patients were followed in parallel in a randomized
manner. Group 2 received ciprofloxacin 500 mg two times a day orally for 4 days starting
the day prior to biopsy and ceftriaxone 1 g intramuscularly 20 minutes prior to biopsy.
Group 3 received the same antibiotic regimen as group 2 and also underwent isopropyl
alcohol needle washing.
Results
All study groups were demographically equivalent. Microscopic bacterial counts were
substantially decreased after isopropyl alcohol needle washing. Incidence of postbiopsy
sepsis in groups 1 (n = 313), 2 (n = 259), and 3 (n = 257) was 3.8%, 2%, and 0%, respectively
(analysis of variance; P = .006). Risk factors for sepsis included elevated body mass index, Charlson Comorbidity
Score, and presence of type 2 diabetes mellitus.
Conclusion
There was a significant reduction in the incidence of sepsis after prostate biopsy
using a combination of a ciprofloxacin-ceftriaxone 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.
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Article info
Publication history
Published online: February 27, 2018
Accepted:
February 14,
2018
Received:
December 21,
2017
Footnotes
Financial Disclosure: The authors declare that they have no relevant financial interests.
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
