[Antibiotic prophylaxis in transrectal prostate biopsy]

Area of Science:

• Urology
• Infectious Diseases

Context:

• Transrectal ultrasound-guided prostate biopsies carry a risk of genitourinary infections (GUI).
• Current antibiotic prophylaxis protocols vary significantly between medical centers.
• There is a lack of established guidelines for antibiotic prophylaxis before prostate biopsies.

Purpose:

• To review and synthesize existing literature on antibiotic prophylaxis protocols for transrectal ultrasound-guided prostate biopsies.
• To evaluate the efficacy of antibiotic prophylaxis in reducing GUI incidence.

Summary:

• A review of five articles indicated that antibiotic prophylaxis is associated with lower rates of bacteriuria and infectious complications compared to placebo.
• Escherichia coli is the most frequent causative agent of GUI.
• Oral quinolones are commonly used for prophylaxis. Studies found no significant differences between oral versus parenteral administration or between single-dose/short-term versus longer courses.

Impact:

• Prophylactic antibiotic administration is beneficial in preventing GUIs post-prostate biopsy.
• Optimal timing and choice of oral antibiotics (single or short-term course) should consider microbial sensitivities.
• Further research is required to ascertain the role of pre-biopsy enemas in mitigating infectious complications.