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Ciprofloxacin: single versus multiple doses in transrectal ultrasound guided prostate biopsy

Muhammad Rafiq1, Fawzy Farag1,2, Kate Manley1

  • 1Department of Urology, Norfolk & Norwich University Hospital, Norwich, United Kingdom.

Central European Journal of Urology
|May 13, 2020
PubMed
Abstract

Insights

A single dose of ciprofloxacin before prostate biopsy is as effective as multiple doses in preventing sepsis. This approach reduces fluoroquinolone exposure, minimizing side effects and antimicrobial resistance.

Area of Science:

  • Urology
  • Infectious Diseases
  • Pharmacology

Background:

  • Growing concerns exist regarding fluoroquinolone overuse, linked to severe side effects and antimicrobial resistance.
  • European guidelines recommend against routine fluoroquinolone prophylaxis in urological procedures.
  • Investigating methods to reduce unnecessary fluoroquinolone exposure is crucial.

Purpose of the Study:

  • To compare hospital admissions for sepsis after transrectal ultrasound (TRUS)-guided prostate biopsies.
  • To evaluate differences between single and multiple fluoroquinolone prophylactic doses.

Main Methods:

  • Retrospective analysis of 200 TRUS-guided prostate biopsies (June 2017-September 2018).
  • Group 1 (n=100): Single 750 mg ciprofloxacin dose pre-biopsy + 3 days of 250 mg ciprofloxacin BD.
  • Group 2 (n=100): Single 750 mg ciprofloxacin dose pre-biopsy.
  • Analysis included pre- and post-biopsy urine cultures and hospital readmission rates for urosepsis.

Main Results:

  • 1% of patients in each group were admitted for Escherichia coli sepsis.
  • Urinary tract infections requiring antibiotics occurred in 4% of Group 1 versus 1% in Group 2.
  • No statistically significant difference in infectious complications between the groups (p >0.05).

Conclusions:

  • A single prophylactic dose of ciprofloxacin is as effective as multiple doses for TRUS-guided prostate biopsies.
  • Avoiding prolonged fluoroquinolone courses reduces potential side effects.
  • This strategy aids in combating the development of resistant pathogens.
Keywords:
antibioticstransrectal ultrasound guided prostate biopsy

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