Login to Access Video or Poster Abstract: MP11-11
Sources of Funding: none

Introduction

To examine the incidence of infective complications post Transrectal Ultrasound Guided Prostate Biopsy (TRUSPB), after transition to pre-operative administration of single dose oral fluoroquinolone. A protocol adopted from the American Urological Association (AUA) recommendations and in line with a Cochrane Database Systematic Review.

Methods

A retrospective study of patients undergoing TRUSPB at St Vincent’s Hospital Melbourne (2002-2016) was performed. In total 766 consecutive patients had TRUSPB; antibiotic prophylaxis between 2002-2014 consisted of 3 days of perioperative oral norfloxacin and intravenous 3rd generation cephalosporin or gentamicin (Group A, n = 687). From November 2014 patients routinely received only a single dose of oral 750mg ciprofloxacin pre-biopsy (Group B, n = 79). Patients were followed up for all postoperative complications requiring emergency department presentation and/or readmission within 30 days of biopsy.

Results

In Group A, 10 of the 687 patients (1.5%) presented with postprocedural fever (Temperature > 37.5C), requiring readmission and intravenous antibiotic treatment. In comparison to 4 of the 79 patients (5.1%) in Group B (p=0.02). Positive blood cultures were isolated in 0.9% (n=6, Group A) versus 3.8% (n=3, Group B), (p=0.02). Two patients in Group B cultured Escherichia Coli sensitive to ciprofloxacin despite receiving a single dose of pre-operative oral Ciprofloxacin. The 4 infectious readmissions in Group B had no additional pre-operative identifiable travel or medical risk factors.

Conclusions

Our study suggests antibiotic prophylaxis using single dose ciprofloxacin is associated with higher readmission with fever, UTI and bacteraemia. The episodes of ciprofloxacin sensitive Escherichia Coli bacteraemia in Group B suggest consideration of long course antibiotic prophylaxis should occur.

Funding

none