Comparison of Three Different Antibiotic Protocols Used as Prostate Biopsy Prophylaxis in Terms of Infectious Complications

Abstract

Objective: Development of urinary infection and sepsis following prostate biopsy procedure is the main problem. Despite use of antibiotic prophylaxis, which becomes a routine procedure in prostate biopsy, urinary infection and sepsis may significantly be observed. Furthermore, there is no consensus in terms of the type and duration of prophylaxis. This study aimed to compare the incidence of infectious complications, which developed during 3 different prophylaxis protocols used in our institution.

Materials and Methods: Four hundred and eighteen prostate biopsy procedures performed in our institution between 2010 and 2017 were evaluated retrospectively. Patients were divided into 3 groups based on their prophylactic antibiotic protocols. First group patients (n=136) were given ciprofloxacin and gentamicin 80 mg. Second group patients (n=180) were given cefpodoxime and gentamicin 80 mg. Third group patients (n=102) were given cefpodoxime and gentamicin 160 mg. Three groups were compared in terms of post-biopsy infectious complications. SPSS 20 statistical program was used for data evaluation.

Results: There was no statistically significant difference between the groups in terms of age, prostate specific antigen level and prostate volume. Urinary tract infection following the prostate biopsy was seen in 11 (8.1%) patients in group 1, 8 (4.4%) patients in group 2 and, 2 (1.9%) patients in group 3. Five of these patients were hospitalized due to deterioration of their overall health status and fever. When 3 groups were statistically compared, infection incidence was significantly different between the first and the third group (p<0.05).

Conclusion: Bacterial resistance against fluoroquinolones is particularly increasing day by day. Fluoroquinolone resistance in Escherichia coli strains in our country is reported between 39-63%. In this study, infectious complications were found to be less in cefpodoxime plus gentamicin 160 mg prophylaxis, when compared to ciprofloxacin plus gentamicin 80 mg. Replacing quinolones with cefpodoxime and gentamicin in the antibiotic prophylaxis protocols used before prostate biopsy can minimize risk of infection.