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Prosbiotate: a multicenter, prospective analysis of infectious complications after prostate biopsy
Franck Bruyère1, Sandra Malavaud2, Philippe Bertrand3
1Urology Department, Centre Hospitalier Régional Universtaire, Tours, France; Université Francois Rabelais de Tours, Pôle de Recherche et d'Enseignement Supérieur Centre, Val de Loire Université, Tours, France.
Purpose:
Prostate biopsy side effects have a role in the controversy over screening for prostate cancer. We measured the precise incidence of infection after prostate biopsy and determined risk factors.
Materials And Methods:
We performed a prospective, multicenter study in France from April to June 2013. All prostate biopsies done during this period were included in study. A web based questionnaire was used to identify patient characteristics, biopsy methods and postoperative infectious episodes. External audit helped ensure data completeness. The primary outcome was the post-biopsy infection rate. We determined risk factors for infectious complications using univariate and multivariate analysis.
Results:
The study included 2,718 patients, of whom 6% reported receiving antibiotics in the previous 6 months and 7.4% had a history of prostatitis. Recommended antibiotic prophylaxis consisting of 2 fluoroquinolone tablets 2 hours before examination for prostate biopsy was noted in 78.3% of cases. Post-biopsy sepsis was found in 76 subjects (2.8%). On multivariate analysis predictors of post-biopsy sepsis were noncompliance with antibiotic prophylaxis guidelines (OR 2.3, 95% CI 1.4-3.9, p = 0.001), antibiotic treatment in the previous 6 months (OR 2.1, 95% CI 1.1-3.9, p = 0.015) and a history of prostatitis (OR 1.7, 95% CI 1.2-2.4, p = 0.002).
Conclusions:
In this study the incidence of post-prostate biopsy sepsis was 2.8% and no deaths were reported. Risk factors identified on multivariate analysis were noncompliance with antibiotic prophylaxis according to guidelines, antibiotic treatment in the previous 6 months and a history of prostatitis.
Insights
Prostate biopsy sepsis occurred in 2.8% of patients. Key risk factors for infection include not following antibiotic guidelines, recent antibiotic use, and a history of prostatitis. Adherence to prophylaxis is crucial for patient safety.
Area of Science:
- Urology
- Infectious Diseases
- Public Health
Background:
- Prostate biopsy is a common procedure for diagnosing prostate cancer.
- Infection is a significant side effect that contributes to the debate surrounding prostate cancer screening.
- Understanding the precise incidence and risk factors for post-biopsy infection is critical for patient safety and informed screening decisions.
Purpose of the Study:
- To accurately measure the incidence of infection following prostate biopsy.
- To identify specific risk factors associated with post-prostate biopsy infectious complications.
Main Methods:
- A prospective, multicenter study was conducted in France, including all prostate biopsies performed during April-June 2013.
- A web-based questionnaire collected data on patient characteristics, biopsy methods, and postoperative infections.
- Univariate and multivariate analyses were employed to determine risk factors for infectious complications.
Main Results:
- The study included 2,718 patients, with a post-biopsy sepsis rate of 2.8% (76 subjects).
- Significant predictors of post-biopsy sepsis included noncompliance with antibiotic prophylaxis (OR 2.3), recent antibiotic treatment (OR 2.1), and a history of prostatitis (OR 1.7).
- Approximately 78.3% of patients received recommended fluoroquinolone prophylaxis, but noncompliance was a key risk factor.
Conclusions:
- The incidence of post-prostate biopsy sepsis in this study was 2.8%, with no reported deaths.
- Noncompliance with antibiotic prophylaxis guidelines, prior antibiotic use, and a history of prostatitis are significant risk factors for sepsis.
- Adherence to established antibiotic prophylaxis protocols is essential to minimize infectious complications after prostate biopsy.
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