Antibiotic Prophylaxis in Prostate Biopsies: Contemporary Practice Patterns in Germany
Katharina Boehm1, Fabian P Siegel2, Laila Schneidewind3
1Universitätsmedizin Mainz, Klinik und Poliklinik für Urologie und Kinderurologie, Mainz, Germany.
Frontiers in Surgery
|February 9, 2018
Summary
Most urologists use extended antibiotic prophylaxis (apx) for prostate biopsies (pbx), often with fluoroquinolones. Practices are adapting to rising resistance by using rectal swab and urine cultures.
Area of Science:
- Urology
- Infectious Disease
Background:
- Prostate biopsy (pbx) is a common urological procedure.
- Urinary tract infections, including sepsis, are significant complications.
- Current antibiotic prophylaxis (apx) recommendations are scarce.
Purpose of the Study:
- To investigate the duration and spectrum of antimicrobial prophylaxis for transrectal and transperineal pbx.
- To gather data on current practices in hospital and practice settings.
Main Methods:
- A questionnaire was distributed to German urologists.
- Data collected included pbx frequency, apx duration/type, lubricant use, and cultures.
- 478 urologists responded, with 15.5% being residents.
Main Results:
- 98% of urologists prescribe apx, predominantly fluoroquinolones.
- The median apx duration is 4 days; only 10.1% use single-shot apx.
- Urine and rectal swab cultures are used by 45.5% and 24.4% of respondents, respectively.
Conclusions:
- Most urologists use extended apx for both transrectal and transperineal pbx.
- Perineal pbx is not yet an established alternative.
- Urologists are aware of fluoroquinolone resistance and are incorporating cultures; further studies on alternatives to 5-day apx are needed.
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