[Antibiotic prophylaxis in prostate biopsy].

Area of Science:

• Urology
• Infectious Disease Prevention
• Pharmacology

Context:

• Prostate biopsy is a common urological procedure.
• Transrectal prostate biopsy carries a higher risk of infectious complications than transperineal.
• Antibiotic prophylaxis is widely used to mitigate these risks, particularly for transrectal procedures.

Purpose:

• To review current practices and recommendations for antibiotic prophylaxis in prostate biopsies.
• To discuss the factors influencing antibiotic choice, timing, and efficacy.
• To emphasize the importance of tailoring prophylaxis to patient risk and procedure type.

Summary:

• Antibiotic prophylaxis is crucial for reducing infection rates after transrectal prostate biopsies, aiming for rates below 5%.
• Optimal prophylaxis involves considering patient infective risk, the specific biopsy route (transrectal vs. transperineal), and potentially using broad-spectrum antibiotics.
• Commonly, a 1-3 day course of fluoroquinolones is used, though single-dose regimens show promise. Factors like tolerability, cost, and route of administration are also important.

Impact:

• Implementing appropriate antibiotic prophylaxis can significantly decrease the incidence of post-biopsy infections.
• This preventative measure is cost-effective when compared to the expenses associated with treating serious infectious complications.
• Guidelines recommend prophylaxis for high-risk patients and all transrectal prostate biopsy cases.