Comparison of Urinary Tract Infection Rates Between Transperineal Prostate Biopsies with and Without Prophylactic
Seok Cho1, Dae Young Jun2, Joo Yong Lee3,4
1Department of Urology, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang 10380, Republic of Korea.
Medicina (Kaunas, Lithuania)
|February 26, 2025
Summary
Antibiotic prophylaxis is not significantly different for preventing urinary tract infections (UTIs) after transperineal prostate biopsies. Further research is needed, though high-risk patients may still benefit.
Area of Science:
- Urology
- Infectious Disease
Background:
- Emerging evidence suggests antibiotic prophylaxis may not be essential for transperineal prostate biopsies.
- European Association of Urology (EAU) Guidelines highlight the need for more research on this topic.
Purpose of the Study:
- To compare urinary tract infection (UTI) and sepsis rates in patients undergoing transperineal prostate biopsies with and without antibiotic prophylaxis.
Main Methods:
- A meta-analysis was conducted, searching PubMed, EMBASE, and Cochrane Library up to June 2024.
- Included studies compared UTI and sepsis rates in transperineal prostate biopsy patients receiving prophylaxis versus those who did not.
- Nine studies (2 RCTs, 7 non-RCTs) were analyzed using the Scottish Intercollegiate Guidelines Network checklist for quality assessment.
Main Results:
- No significant difference in UTI rates was found between the prophylaxis and no-prophylaxis groups (OR: 1.07, 95% CI: 0.50-2.31).
- Sepsis rates also showed no significant difference between the groups (OR: 1.35, 95% CI: 0.36-5.12).
- Statistical heterogeneity was low (I² = 0%) for both outcomes.
Conclusions:
- Transperineal prostate biopsies with or without antibiotic prophylaxis show comparable UTI and sepsis rates.
- Antibiotic prophylaxis may still be beneficial for patients at high risk of UTIs.
- Larger, prospective randomized trials are recommended for definitive conclusions.
Related Concept Videos
01:26Urinary Tract Infection I: Introduction
1.3K
Urinary tract infections (UTIs) impact various parts of the urinary system, including the kidneys, ureters, bladder, and urethra. These infections are generally bacterial, with Escherichia coli being the most common causative agent, often originating from the gastrointestinal tract. However, other bacteria, such as Staphylococcus saprophyticus, Klebsiella pneumoniae, and Proteus mirabilis, are also known to cause UTIs. The type, location, and underlying complexity of the UTI guide both...
1.3K
01:25Urinary Tract Infection II: Pathophysiology
1.5K
The pathophysiology of urinary tract infections (UTIs) encompasses several progressive stages, beginning with bacterial colonization and culminating in potential systemic complications if untreated. UTIs are primarily initiated by bacteria, such as Escherichia coli, which often originate from the gastrointestinal tract and migrate to the urinary system through the periurethral area. This migration can occur via several routes, including improper hygiene practices, sexual activity, or...
1.5K
01:30Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care
440
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...
440
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
859
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...
859
01:26Urine Studies II: Urine Culture and Sensitivity Test
3.0K
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...
3.0K
01:28Microbiota of the Urogenital Tract
59
The human urogenital system, once thought to be sterile in healthy individuals, is now recognized as a complex microbial habitat. Advancements in molecular sequencing techniques have revealed that even in healthy adults, the kidneys and bladder harbor microbial populations similar to those found in the distal urethra, albeit in much lower abundance. These resident microorganisms, while generally innocuous, can become opportunistic pathogens under conditions that alter the urogenital...
59