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RESIDENT’S CORNER

Aprospective randomized trial of 1-day versus 3-day antibiotic prophylaxis for transrectal ultrasound guided prostate biopsy

Robert Sabbagh, Michael Mc Cormack, François Péloquin, Raymond Faucher, Jean-Paul Perreault, Paul Perrotte, Pierre I. Karakiewicz, Fred Saad

Division of Urology, Centre Hospitalier de l’Université de Montréal, Université de Montréal, Montréal, Québec, Canada
Address correspondence to Fred Saad, MD, Department of Urology, Centre Hospitalier de l'Universitéde Montréal, 1560 Sherbrooke Street East, Montreal, Quebec H2L 4M1 Canada

Canadian Journal of Urology 2004, 11(2), 2216-2219.

Abstract

Purpose: To compare the incidence of infection between a 1 day and a 3 day antibiotic prophylaxis regimen for transrectal ultrasound (TRUS) guided prostate biopsy in a prospective, randomized open-label trial.
Materials and methods: TRUS examination was performed in the left lateral decubitus position using a Brüel and Kjaer 7 MHz rectal probe. Biopsies were carried out with an 18 gauge Tru-cut needle fired by the hand-held Biopsy gun. An average of eight core biopsies (range 6 to 12) was taken. From May 15, 2000 to May 16, 2001, 363 patients were enrolled in this study. Patients were randomized to receive either 1 day or 3 days of fluoroquinolone antibiotic prophylaxis, consisting of either ciprofloxacin or levofloxacin orally. Antibiotics were begun at least 1 hour prior to biopsy. Seven days later, telephone follow-up was obtained.
Results: Two (0.55%) of the 363 patients, one in each group, had an episode of sepsis. No urinary tract infection was reported. Traumatic complications were only minor and no significant difference was observed between both groups: hematospermia (p>0.4), hematuria (p>0.1) and rectorrhagia (p>0.2) being reported most frequently.
Conclusion: There is no clinically nor statistically significant difference between a 1 day and 3 day antibiotic prophylaxis regimen for patients undergoing TRUS guided biopsies.

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