Antibiotic prophylaxis and complications following prostate biopsies: A systematic review

TY - JOUR

T1 - Antibiotic prophylaxis and complications following prostate biopsies

T2 - A systematic review

AU - Klemann, Nina

AU - Helgstrand, John Thomas

AU - Brasso, Klaus

AU - Vainer, Ben

AU - Iversen, Peter

AU - Røder, Martin Andreas

PY - 2017/1

Y1 - 2017/1

N2 - Introduction: Transrectal ultrasound-guided biopsies (TRUS-gb) are associated with both mild and serious complications. Prophylactic antibiotics reduce the risk of septicaemia and mortality; however, no international consensus exists on the timing and duration of antibiotics, including the optimal drug strategy. We reviewed the current evidence supporting use of prophylactic antibiotics and the risk of complications following prostate biopsies. Methods: This review was drafted in accordance with the Prisma Guidelines. The PubMed, Embase and Cochrane databases were searched. Results: A total of 19 eligible trials were identified. One trial demonstrated a significant reduction in the risk of infection after biopsy and reported that oral ciprofloxacin as either a single-dose or a three-day regimen was superior to oral chloramphenicol and norfloxacin. Of three studies investigating the timing of the first dose of antibiotic, one study found that administration 24 h before biopsy versus administration immediately before reduced the relative risk of post-biopsy infection by 55%. Seven studies compared different durations of antibiotic prophylaxis. None showed any benefit from continuing prophylaxis beyond a single dose or a one-day regimen. Conclusion: Evidence supporting a specific antibiotic regimen for TRUS-gb prophylaxis is scarce. Widespread use of fluoroquinolone prophylaxis may be associated with an increase in resistant Escherichia coli strains, posing a potentially major health issue in the future.

AB - Introduction: Transrectal ultrasound-guided biopsies (TRUS-gb) are associated with both mild and serious complications. Prophylactic antibiotics reduce the risk of septicaemia and mortality; however, no international consensus exists on the timing and duration of antibiotics, including the optimal drug strategy. We reviewed the current evidence supporting use of prophylactic antibiotics and the risk of complications following prostate biopsies. Methods: This review was drafted in accordance with the Prisma Guidelines. The PubMed, Embase and Cochrane databases were searched. Results: A total of 19 eligible trials were identified. One trial demonstrated a significant reduction in the risk of infection after biopsy and reported that oral ciprofloxacin as either a single-dose or a three-day regimen was superior to oral chloramphenicol and norfloxacin. Of three studies investigating the timing of the first dose of antibiotic, one study found that administration 24 h before biopsy versus administration immediately before reduced the relative risk of post-biopsy infection by 55%. Seven studies compared different durations of antibiotic prophylaxis. None showed any benefit from continuing prophylaxis beyond a single dose or a one-day regimen. Conclusion: Evidence supporting a specific antibiotic regimen for TRUS-gb prophylaxis is scarce. Widespread use of fluoroquinolone prophylaxis may be associated with an increase in resistant Escherichia coli strains, posing a potentially major health issue in the future.

M3 - Review

C2 - 28007054

AN - SCOPUS:85009348301

SN - 1603-9629

VL - 64

JO - Danish Medical Journal

JF - Danish Medical Journal

IS - 1

M1 - A5323

ER -