OBJECTIVE: To evaluate whether the addition of a single dose of an aminoglycoside to a fluoroquinolone-based prophylaxis regime would decrease septic complications associated with transrectal prostate biopsy. METHODS: A retrospective survey of all patients undergoing transrectal ultrasound guided prostate biopsy (TRUS-PB) between 2001 and 2012 at Hadassah Hebrew University Medical Center was performed. All patients received prophylactic ofloxacin for 3 days. From 2008, patients received an augmented protocol, consisting also of a single injection of gentamicin. The dose of the aminoglycoside was left to the discretion of the attending physician. RESULTS: Of 4655 patients, 110 patients (2.4%) were admitted because of urosepsis. Ninety patients (82%) had a positive urine or blood culture or both. From 2008, among 581 patients treated solely with ofloxacin, the infection rate was 3.6%, and among the 538 patients who also received 80 mg gentamicin, the rate of sepsis was 3.5% (P = 1.0). Among the 376 patients treated with gentamicin, 160 mg infection rate was 2.7% (P = .27). The sepsis rate dropped significantly to 0.6% (P = .04) among the 169 patients who received 240 mg gentamicin during the biopsy. CONCLUSION: Addition of a single dose of gentamicin 240 mg resulted in a significant drop in infection rates after TRUS-PB. However, addition of 80 mg or 160 mg gentamicin had no significant effect on the infection rates. We recommend adding a single dose of gentamicin 240 mg to all patients with normal kidney function undergoing TRUS-PB during the procedure.
OBJECTIVE: To evaluate whether the addition of a single dose of an aminoglycoside to a fluoroquinolone-based prophylaxis regime would decrease septic complications associated with transrectal prostate biopsy. METHODS: A retrospective survey of all patients undergoing transrectal ultrasound guided prostate biopsy (TRUS-PB) between 2001 and 2012 at Hadassah Hebrew University Medical Center was performed. All patients received prophylactic ofloxacin for 3 days. From 2008, patients received an augmented protocol, consisting also of a single injection of gentamicin. The dose of the aminoglycoside was left to the discretion of the attending physician. RESULTS: Of 4655 patients, 110 patients (2.4%) were admitted because of urosepsis. Ninety patients (82%) had a positive urine or blood culture or both. From 2008, among 581 patients treated solely with ofloxacin, the infection rate was 3.6%, and among the 538 patients who also received 80 mg gentamicin, the rate of sepsis was 3.5% (P = 1.0). Among the 376 patients treated with gentamicin, 160 mg infection rate was 2.7% (P = .27). The sepsis rate dropped significantly to 0.6% (P = .04) among the 169 patients who received 240 mg gentamicin during the biopsy. CONCLUSION: Addition of a single dose of gentamicin 240 mg resulted in a significant drop in infection rates after TRUS-PB. However, addition of 80 mg or 160 mg gentamicin had no significant effect on the infection rates. We recommend adding a single dose of gentamicin 240 mg to all patients with normal kidney function undergoing TRUS-PB during the procedure.
Authors: Rachel S Hayward; Jan Harding; Rob Molloy; Lucy Land; Kate Longcroft-Neal; David Moore; Jonathan D C Ross Journal: Br J Clin Pharmacol Date: 2017-11-03 Impact factor: 4.335
Authors: Chunwoo Lee; Dalsan You; In Gab Jeong; Jun Hyuk Hong; Myung-Soo Choo; Hanjong Ahn; Tai Young Ahn; Choung-Soo Kim Journal: Korean J Urol Date: 2015-06-02