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Rising incidence of acute prostatitis following prostate biopsy: fluoroquinolone resistance and exposure is a

Ashraf A Mosharafa1, Mohamed H Torky, Wael M El Said

  • 1Department of Urology, Cairo University, Cairo, Egypt. amosharafa@kasralainyurology.net

Urology
|July 26, 2011
PubMed
Abstract

Insights

Prior fluoroquinolone use significantly increases the risk of acute prostatitis after transrectal prostate biopsy. Current antibiotic prophylaxis may need adjustment due to rising fluoroquinolone resistance in common pathogens.

Area of Science:

  • Urology
  • Infectious Diseases
  • Antimicrobial Stewardship

Background:

  • Transrectal prostate biopsy is a common procedure for diagnosing prostate cancer.
  • Infection-related complications, particularly acute prostatitis, are a concern.
  • Rising antimicrobial resistance necessitates re-evaluation of prophylaxis protocols.

Purpose of the Study:

  • To determine the incidence and risk factors for infection complications post-transrectal prostate biopsy.
  • To assess the impact of prior fluoroquinolone use on complication rates.
  • To inform adjustments to current antimicrobial prophylaxis guidelines.

Main Methods:

  • Retrospective chart review of 107 patients undergoing transrectal ultrasound-guided prostate biopsy (2008-2010).
  • Evaluation of risk factors including prior fluoroquinolone use, diabetes, constipation, enema use, and prostatitis.
  • Bacteriology and antibiotic susceptibility testing for positive urine and blood samples in cases of acute prostatitis.

Main Results:

  • Acute prostatitis occurred in 9.3% of patients.
  • Prior fluoroquinolone use was a significant risk factor (17.1% vs. 4.5%, P=.042).
  • Escherichia coli was the most common pathogen, with 85.7% of Gram-negative isolates showing fluoroquinolone resistance.

Conclusions:

  • Previous fluoroquinolone exposure is a key risk factor for acute prostatitis after prostate biopsy.
  • High rates of fluoroquinolone resistance among isolated pathogens necessitate alternative prophylaxis strategies.
  • Consideration of alternative antimicrobial prophylaxis is recommended for patients with recent quinolone intake.

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