[Meta-analysis of antibiotic prophylaxis for postoperative bacteriuria in patients undergoing transrectal prostatic...

To investigate whether antibiotic prophylaxis can reduce the risk of postoperative bacteriuria in patients undergoing transrectal prostatic biopsy (TPB) who have sterile preoperative urine.

MEDLINE, EMBASE, Cochrane Collaboration Reviews, CMCC, and CNKI were searched for randomized controlled trials (RCTs) comparing antibiotic prophylaxis with placebo/blank controls for patients undergoing TPB with preoperative sterile urine. The search strategy was made according to the Collaborative Review Group search strategy. Data were extracted by two reviewers using the designed extraction form. The software RevMan4.2 was used to review management and data analysis.

67 relevant RCTs were found, of which 12 qualified ones were included into the analysis. Antibiotic prophylaxis significantly decreased the rate of bacteriuria within the period 1 week after TPB (corresponding pooled relative risk (RR) and 95% CI was 0.32 (0.23 - 0.46, P < 0.01). The effective antibiotics included quinolones and quinolones combined with nitroimidazole, with the pooled RR and 95% CI of 0.31 (0.18 - 0.53, P < 0.01) and 0.32 (0.17 - 0.60, P = 0.0004) respectively. There was no significant difference in the effect between short treatment course protocol and long course protocol (P = 0.41).

Prophylactic antibiotics can significantly decrease the incidence of post-TPB bacteriuria. A significant decrease in bacteriuria incidence can be achieved with a range of antibiotic agents, including quinolones and-quinolones combined with nitroimidazole. Treatment protocols of any duration are effective.