Preprostate Biopsy Rectal Culture and Postbiopsy Sepsis




Transrectal ultrasound-guided biopsy of the prostate (TRUSP) remains the primary procedure for the accurate histologic diagnosis of prostate cancer. Fluoroquinolones (FQs) are still recommended as the agents of choice for antimicrobial prophylaxis for TRUSP despite the alarming increasing incidence of FQ-resistant organisms among men undergoing TRUSP. This article reviews the current TRUSP antimicrobial prophylaxis guidelines, antimicrobial resistance and its implications for these guidelines, the incidence of post-TRUSP infectious complications including urosepsis, the seminal data supporting pre-TRUSP rectal swab (RS), RS technique and protocol, and the current available literature surrounding the efficacy of RS in reducing post-TRUSP infectious complications.




  • •

    Urologists face pay-for-performance concerns, and should consider alteration of their biopsy antibiotic prophylaxis regimen to reduce the risk of biopsy-related infectious complications.




  • •

    Urologists face pay-for-performance concerns, and should consider alteration of their biopsy antibiotic prophylaxis regimen to reduce the risk of biopsy-related infectious complications.




  • •

    RS and post-TRUSP infectious complications




    • It is important, however, that the benefit of empiric antimicrobial prophylaxis with FQs and the recommendations for its use were based on studies predating the twenty-first century, which had a lower prevalence of antibiotic-resistant uropathogens.












  • •

    RS and post-TRUSP infectious complications


    • References



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    Mar 3, 2017 | Posted by in UROLOGY | Comments Off on Preprostate Biopsy Rectal Culture and Postbiopsy Sepsis

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