Three-or Seven-Day Antimicrobial Prophylaxis in Transrectal Ultrasound Guided Prostate Biopsy - Does it Matter?

Three-or Seven-Day Antimicrobial Prophylaxis in Transrectal Ultrasound Guided Prostate Biopsy - Does it Matter?
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Title:Three-or Seven-Day Antimicrobial Prophylaxis in Transrectal Ultrasound Guided Prostate Biopsy - Does it Matter?
Author/Abstract:
Reynaldo A. Aguinaldo, MD; Eduardo R. Gatchalian, MD and Carlos M. Valleza, MD

Department of Urology, Jose R. Reyes Memorial Medical Center
 
Objective: To determine if there is significant difference in the infection rate between three-day and seven-day antimicrobial prophylaxis in transrectal ultrasound (TRUS) guided biopsy of the prostate. Methods: One hundred eighty eight patients from our OPD urology clinic presenting indication for TRUS guided biopsy of the prostate for out-patient work up of prostatic conditions were enrolled. The indication was primarily based on abnormalities of digital rectal examination (DRE) or elevation of PSA levels or both. An open label, non blinded, randomized clinical trial was designed. All 188 patients were randomly separated into two groups: Group I received ciprofloxacin 500 mg a day prior to the procedure and for two days more and Group II received ciprofloxacin 500 mg a day prior to the procedure and for six days more. Results: Of the 188 patients evaluated, 84 patients were placed in Group I while 104 were included in Group II. Pyrexia with bacteriuria after prostate biopsy occurred in three of 84 (3.60%) patients in Group I and five of 104 (4.80%) in Group II. All of them required hospitalization for further evaluation and treatment. Student T-test showed that there is no significant difference in the occurrence of post TRUS guided biopsy of the prostate complications between the two groups (p = 0.6763066). Comparison of proportions (i.e. percentages) also showed no significant difference between the two groups (p = 0.956838). Conclusion: This prospective study showed that with regards to post-TRUS guided biopsy of the prostate, the three day prophylaxis with ciprofloxacin showed no difference against that of the seven day regimen.

Key words: prostate, biopsy prophylaxis
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