Mp53-07 Cancer Detection Rate of Conventional Vs 3d Template Prostate Biopsy in a Mri/us Fusion Device
Year: 2016
Type: article
Abstract: fear of infectious complications can lead to under utilization of active surveillance for prostate cancer.We initiated an enhanced antibiotic prophylactic regimen based on regional infection patterns and patient risk factors.We sought to determine the infectious complication rate before and after implementation of enhanced protocol antibiotic prophylaxis in patients undergoing prostate biopsy.METHODS: 1163 consecutive patients who underwent TRUS-Bx between 1/2011-9/2013 were compared with 375 control patients who underwent TRUS-Bx in 2009.All patients received an enema prior to biopsy.Routine antibiotic prophylaxis was based on regional resistance pattern: a quinolone plus Bactrim DS for 24 hours.All participants were screened to identify patients at risk of harboring resistant bacteria (recent antibiotic use; overseas travel; recent UTI).They received enhanced antibiotic regimen (oral antibiotic plus Gentamicin i.m.).Rectal cultures were not performed.Electronic records were reviewed including office notes, ER visits, hospital admissions, phone messages, scanned records and new prescriptions written within 30 days.Infectious complication was defined as any hospital admission, ER visit, unscheduled office visits or additional antibiotic.RESULTS: Overall, infectious complication rate was 2.3% (27/1163).Hospital admission was required in 11 (0.9%) patients for various reasons including 1 each with quinolone -resistant and -sensitive E. Coli.Urosepsis was noted in 4 (0.3%) of men, with quinolone resistant E. Coli was isolated in only one case.Fever (> 101 F) was recorded in 11 (0.9%) and additional outpatient oral antibiotics were given in 16 (1.9%)men for urinary symptoms, often without urine culture.Urine cultures were positive in 9 (0.7%) patients, of whom quinolone-resistant bacteria were isolated in 3 cases.Overall, the rate of infectious complications and sepsis in the comparison group was 1.3% and 0.3%, respectively, and were similar to the recent cohort.CONCLUSIONS: In this antibiotic resistance era, it's possible to maintain a low and stable infectious complication rate by implementing enhanced prophylactic antibiotics protocol.Majority of infectious complications are caused by quinolone sensitive strains.Recommendations for specific antibiotic coverage or pre-biopsy rectal cultures are not universally applicable.Frequent review of the local infection rates and resistance patterns should inform the discussion regarding prophylactic measures.
Source: The Journal of Urology
Authors: Shyam Natarajan, Jiaoti Huang, Leonard Marks
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2317968052