@Article{,
AUTHOR = {Alex J. Xu, Sameer Thakker, Vyom Sawhney, Rozalba Gogaj, Fjolla Vokshi, James S. Wysock},
TITLE = {Antibiotic resistance in patients undergoing serial prostate biopsies: risk factors and impact on clinical outcomes},
JOURNAL = {Canadian Journal of Urology},
VOLUME = {31},
YEAR = {2024},
NUMBER = {1},
PAGES = {11767--11774},
URL = {http://www.techscience.com/CJU/v31n1/59606},
ISSN = {1488-5581},
ABSTRACT = {<b>Introduction:</b> We evaluate the rate of developing
ciprofloxacin resistance in patients undergoing repeat
prostate biopsies (PBx), associated risk factors, and impact
on complications.<br/>
<b>Materials and methods:</b> We retrospectively evaluated
pre-procedural rectal culture (RCx) data in men
undergoing PBx from 1/1/2016 to 1/15/2021. Univariate
and multivariate logistic regression were utilized to
identify risk factors associated with development of
antibiotic resistance. Complication rates were compared
between ciprofloxacin-sensitive and ciprofloxacin
resistant patients.<br/>
<b>Results:</b> A total of 743 men underwent initial RCx.
Initial RCx detected ciprofloxacin resistance in 22%
of patients. A history of diabetes (p = 0.01), > 2 prior
prostate biopsies (p = 0.01), and ciprofloxacin use (p = 0.002) were significant risk factors for ciprofloxacin
resistance on initial RCx. The rate of new ciprofloxacin
resistance following biopsy with standard ciprofloxacin
prophylaxis on 1st and 2nd exposure was 17.2% and
9.1% respectively. The number of biopsy cores, interval
antibiotic exposure and interval procedures performed
between first and second RCx were not significant
predictors of developing ciprofloxacin resistance. Patients
who received a non-ciprofloxacin antibiotic between first
and second RCx did not develop ciprofloxacin resistance.
Antibiotic resistance profile did not significantly affect
the rate or type of complications after various prostate
procedures.<br/>
<b>Conclusions:</b> Serial exposure to standard antibiotic
prophylaxis for PBx and associated procedures can lead
to development of ciprofloxacin resistance after each
subsequent exposure. This carries important implications
for serial biopsy and highlights the role for RCx prior to
repeat biopsy.},
DOI = {}
}