Preoperative Antibiotics Before Bladder Biopsy: Are They Necessary?

Area of Science:

• Urology
• Infectious Disease Prevention

Background:

• Antibiotic prophylaxis is often recommended for bladder biopsies.
• Increased antibiotic use raises concerns about stewardship and resistance.

Purpose of the Study:

• To compare postoperative infectious outcomes of office bladder biopsies without antibiotics versus operating room biopsies with antibiotics.
• To evaluate the necessity of preoperative antibiotic prophylaxis for bladder biopsies.

Main Methods:

• Retrospective review of 216 bladder biopsies (office vs. operating room) between July 2014 and August 2015.
• Comparison of infection outcomes including bacteriuria, urinary tract infection (UTI), and febrile UTI.
• Exclusion of patients with recent UTI or antibiotic use.

Main Results:

• No significant difference in UTI rates (0.94% vs. 0.91%) or febrile UTI (0% vs. 0.91%) between office and operating room groups.
• Similar incidence of new urinary symptoms and post-procedural bacteriuria in both groups.
• Statistical analysis showed no significant difference (P > 0.05) for all measured outcomes.

Conclusions:

• Preoperative antibiotic prophylaxis may not provide additional benefit for select patients undergoing bladder biopsy.
• Current guidelines for antibiotic use in bladder biopsies should be re-evaluated.
• Reducing unnecessary antibiotic use is crucial for antibiotic stewardship.