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Prostate needle biopsy infection after four or six dose ciprofloxacin
D M Janoff1, D W Skarecky, C E McLaren
1Division of Urology, University of California, UC Irvine Medical Center, Orange, California 92868, USA.
Objective:
This retrospective analysis is to determine rates of clinical infection after prostate needle biopsy with four versus six doses of ciprofloxacin to previous literature.
Materials And Methods:
Two groups were treated with pre and post biopsy 500 mg of ciprofloxacin twice daily by either six doses (n=337) or four doses (n=288) with the first dose given 24 or 12 hours prior to the procedure respectively.
Results:
Six (0.96%) of the 625 patients had symptomatic urinary tract infections with a positive urinalysis and/or culture. One (0.3%) infection occurred among patients receiving six doses of ciprofloxacin, and five infections (1.7%), were identified among four dose patients. Two febrile episodes occurred in the four dose group, one requiring hospitalization.
Conclusion:
A low infection rate associated with prophylactic regimens. Six doses of ciprofloxacin appears more effective than four doses in reducing the clinical and febrile infection rate following ultrasound guided biopsy of the prostate. No obvious financial benefit was observed.
Insights
Six doses of ciprofloxacin significantly reduced infection rates after prostate biopsy compared to four doses. This finding supports optimizing antibiotic prophylaxis for prostate biopsy procedures to improve patient outcomes.
Area of Science:
- Urology
- Infectious Diseases
- Pharmacology
Background:
- Prostate needle biopsy is a common urological procedure.
- Infection is a potential complication following prostate biopsy.
- Antibiotic prophylaxis is standard practice to minimize infection risk.
Purpose of the Study:
- To compare the clinical infection rates after prostate needle biopsy using four versus six doses of ciprofloxacin.
- To evaluate the efficacy of different ciprofloxacin dosing regimens in preventing post-biopsy infections.
Main Methods:
- Retrospective analysis of 625 patients undergoing prostate needle biopsy.
- Patients received either four or six doses of ciprofloxacin (500 mg twice daily) pre- and post-procedure.
- Infection rates were assessed based on symptomatic urinary tract infections, urinalysis, and/or culture.
Main Results:
- Overall infection rate was 0.96% (6/625 patients).
- Six-dose regimen had a lower infection rate (0.3%) compared to the four-dose regimen (1.7%).
- Two febrile episodes occurred in the four-dose group, with one requiring hospitalization.
Conclusions:
- Prophylactic antibiotic regimens are associated with low infection rates.
- Six doses of ciprofloxacin appear more effective than four doses in reducing clinical and febrile infections post-prostate biopsy.
- No significant financial benefit was observed between the two regimens.