Related Experiment Video

Updated: Jul 18, 2026

Povidone Iodine Rectal Preparation at Time of Prostate Needle Biopsy is a Simple and Reproducible Means to Reduce Risk of Procedural Infection
05:32

Povidone Iodine Rectal Preparation at Time of Prostate Needle Biopsy is a Simple and Reproducible Means to Reduce Risk of Procedural Infection

Published on: September 21, 2015

32.0K

Isepamicin alone as antimicrobial prophylaxis for transrectal prostate needle biopsy: "Do we still need levofloxacin?

Hiroki Yamada1, Kojiro Tashiro1, Yusuke Takahashi1

  • 1Department of Urology, The Jikei University Katsushika Medical Center, 6-41-2 Aoto, Katsushika-ku, Tokyo, 125-8506, Japan.

Journal of Infection and Chemotherapy : Official Journal of the Japan Society of Chemotherapy
|February 8, 2025
PubMed

Insights

Conventional levofloxacin (LVFX) may be unnecessary for prostate biopsies. A study found intravenous isepamicin alone effectively prevented infections, even in high-risk patients, suggesting optimized antibiotic use.

Area of Science:

  • Urology
  • Infectious Diseases
  • Pharmacology

Background:

  • Increasing levofloxacin (LVFX)-resistant Escherichia coli necessitates evaluating antibiotic prophylaxis for transrectal ultrasound-guided prostate needle biopsy (TRP-Bx).
  • Optimizing antibiotic use is crucial to combat resistance and improve patient outcomes.

Purpose of the Study:

  • To determine if conventional prophylactic levofloxacin (LVFX) is required for transrectal ultrasound-guided prostate needle biopsy (TRP-Bx).
  • To assess the efficacy of intravenous isepamicin (ISP) alone versus combined LVFX and ISP for preventing TRP-Bx-related infections.

Main Methods:

  • A comparative study of 636 patients undergoing TRP-Bx, divided into two groups: Group 1 (oral LVFX + IV ISP) and Group 2 (IV ISP only).
  • Inclusion of a high-risk subgroup with factors like large prostate, dysuria, diabetes, or steroid use.
  • Monitoring for febrile genitourinary tract infections (fGUTIs) post-biopsy.

Main Results:

  • No significant difference in fGUTI rates between the two groups (0.3% vs. 0.6%).
  • Febrile genitourinary tract infections (fGUTIs) occurred in only 0.5% of all patients.
  • Intravenous isepamicin (ISP) alone was effective in preventing fGUTIs in both low- and high-risk patients.

Conclusions:

  • Single-dose intravenous isepamicin (ISP) 400 mg appears sufficient for preventing TRP-Bx-related fGUTIs.
  • Conventional levofloxacin (LVFX) prophylaxis may be unnecessary, supporting more judicious antibiotic use in prostate biopsy procedures.
Keywords:
Antimicrobial prophylaxisIsepamicinTransrectal prostate needle biopsy

More Related Videos

Use of MRI-ultrasound Fusion to Achieve Targeted Prostate Biopsy09:11

Use of MRI-ultrasound Fusion to Achieve Targeted Prostate Biopsy

Published on: April 9, 2019

21.4K
A Novel Method to Determine the Longitudinal Antibacterial Activity of Drug-Eluting Materials06:18

A Novel Method to Determine the Longitudinal Antibacterial Activity of Drug-Eluting Materials

Published on: March 3, 2023

1.3K

Related Concept Videos

Pharmaceutical Alternatives: Stability-Related Therapeutic Nonequivalence01:22

Pharmaceutical Alternatives: Stability-Related Therapeutic Nonequivalence

Generic intravenous (IV) drugs are considered bioequivalent to their branded counterparts due to their 100% bioavailability upon administration. However, variations in stability among different drug products can significantly influence their therapeutic performance, even if they are pharmaceutically equivalent.Cefuroxime, a prophylactic antimicrobial, is often used as a single-dose IV injection for patients undergoing coronary artery bypass grafting surgery. A 3 g dose typically provides...
Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care01:30

Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care

A healthcare provider can diagnose a urinary tract infection (UTI) through several methods:Medical History and Symptoms: The provider will take a detailed medical history and ask about symptoms such as frequent urination, burning sensation during urination, and lower abdominal pain.Urinalysis: A clean-catch urine sample is collected in a sterile container and tested for the presence of bacteria, white blood cells (leukocytes), nitrites, blood, and protein. The presence of leukocytes and...
Acute Pyelonephritis II: Diagnostic Studies and Management01:28

Acute Pyelonephritis II: Diagnostic Studies and Management

Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
Imaging Studies V: Intravenous Urography and Retrograde Pyelography01:22

Imaging Studies V: Intravenous Urography and Retrograde Pyelography

IntroductionIntravenous Urography (IVU) and Retrograde Pyelography (RP) are important diagnostic imaging techniques used to evaluate the urinary system. These methods help identify structural abnormalities, obstructions, and functional issues in the kidneys, ureters, and bladder. Both procedures use iodine-based contrast media to enhance the visibility of urinary tract structures on X-ray images, though they differ in their methods and indications.1. Intravenous Urography (IVU)Intravenous...
Urine Studies II: Urine Culture and Sensitivity Test01:26

Urine Studies II: Urine Culture and Sensitivity Test

A urine culture and sensitivity test is a diagnostic procedure used to identify urinary tract bacterial infections and determine the most effective antibiotics for treatment. This test is generally preferred when a patient shows manifestations of a urinary tract infection, such as frequent or painful urination, cloudy or foul-smelling urine, or lower abdominal pain.Purpose of the TestThe primary goals of a urine culture and sensitivity test are to:Determine the specific bacteria causing the...
Inhibitors of Bacterial DNA Synthesis01:28

Inhibitors of Bacterial DNA Synthesis

Bacterial pathogens depend on precise and efficient DNA replication to sustain infection. Two type II topoisomerases—DNA gyrase and topoisomerase IV—are critical to this process, as they resolve DNA supercoiling and unlink chromosomes during replication. Fluoroquinolones, synthetic derivatives of quinolones, exploit this mechanism by stabilizing the transient DNA–enzyme cleavage complex, preventing strand religation, and causing lethal double-strand breaks. These antibiotics are selectively...