Related Experiment Video
Updated: Jun 18, 2026
Povidone Iodine Rectal Preparation at Time of Prostate Needle Biopsy is a Simple and Reproducible Means to Reduce Risk of Procedural Infection
Published on: September 21, 2015
[Antibiotic prophylaxis in transrectal prostate biopsy]
Daniel Muñoz Vélez1, Antoni Vicens Vicens, Mariano Ozonas Moragues
1Servicio de Urología, Hospital Universitario Son Dureta, Palma de Mallorca, España. dr.munoz.velez@gmail.com
Introduction:
Transrectal ultrasound-guided needle biopsy of the prostate is a safe technique, but it is not complication-free, and its most serious complications are genitourinary infections (GUI) and the conditions they cause. The purpose of antibiotic prophylaxis is to reduce this GUI incidence rate. However, no established guidelines exist and there are significant differences among centres where this procedure is performed. The objective of the present report is to review antibiotic prophylaxis protocols described in the literature.
Material And Methods:
We reviewed indexed articles published in English or Spanish and accessible through literature databases.
Results:
Five articles comparing antibiotic prophylaxis with a placebo observe lower bacteriuria and infectious complications percentage rates in the group receiving prophylaxis. In most cases, E. coli is the microorganism responsible for infection. Oral quinolones are the most commonly prescribed prophylactic antibiotics. Three studies of oral vs. parenteral prophylaxis found no differences between the two groups. Three other articles comparing short term and single-dose prophylaxis found no differences between the two groups.
Conclusions:
Administering prophylactic antibiotics is more advantageous than not doing so. The moment for beginning prophylaxis depends on the antibiotic's bioavailability and how it is administered. The chosen antibiotic will preferably be administered orally as a single dose or short term course, according to the sensitivities of prevalent microorganisms. More studies are needed to determine what role pre-biopsy enemas play in reducing infectious complications.
Insights
Prophylactic antibiotics significantly reduce genitourinary infections following prostate biopsies. Oral, single-dose, or short-term antibiotic prophylaxis is recommended based on common bacterial sensitivities, though further research on enemas is needed.
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.
