Login to Access Video or Poster Abstract: MP77-06
Sources of Funding: The lubricant was provided and the microbiological examinations were sponsored by FarcoPharma.

Introduction

Antibiotic resistancy may lead to increasing infection rates at transrectal prostate biopsy (PBx). Previous studies showed promising results by using targeted antibiotic therapy by rectal swab culture. Nonetheless, performing rectal swabs may be time- and cost ineffective. In consequence, there is a strong need for agents that can achieve a reduction of bacteria. Aim of our study was to test, if an antimicrobial lubricant can reduce bacteria.

Methods

Study population consisted of 384 pbx patients who received a rectal swab before and after biopsy in an European single center between March 2013 and June 2015. Patients were randomized for biopsy with pre-interventional instillation of an antimicrobial lubricant (intervention group) or with standard lubricant (control group). Bacteria were semi-quantitatively recorded (≤ 20 colonies: [+]; > 20 colonies, growth only within first streak: +; growth in second streak: ++; growth in third streak: +++). Colonies growing within the ciprofloxacin inhibition zone were identified.

Results

Overall, 384 patients were included in the study. Out of them, 256 (66.7%) were in the intervention group and received antimicrobial lubricant, 128 (33.3%) were in the control group. Median age at biopsy was 65 years and mean PSA-levels was 7.5 ng/ml. _x000D_ In patients of the intervention group, semi-quantitative bacterial count was statistically significantly lower after instillation of antimicrobial lubricant(p<0.001). In the control group, no statistically significant difference was recorded at the bacteria count of the second rectal swab vs. bacteria count of the first rectal swab(p=0.4). _x000D_ Ciprofloxacin-resistance was shown in overall 30 (7.8%) patients. Instillation of antimicrobial lubricant reduced ciprofloxacin-resistant bacteria from 24 (9.4%) to 15 (5.9%), but reduction did not achieve statistical significance (p=0.5). For the control group, number of ciprofloxacin-resistance bacteria were comparable at first vs. second rectal swab (6 (4.7%) vs. 4 (3.1%); p=0.7)._x000D_

Conclusions

Semi-quantitatively colonie count was significantly lower in patients of the intervention group (p<0.001). Preinterventional overall ciprofloxacin resistance rate was 7.8%. This is relatively low compared to other studies. In our study, the antimicrobial lubricant reduced ciprofloxacin resistant bacteria, but due to the low incidence the reduction was not significant. Our results show that antimicrobial lubricants might be helpful in patients with high risk for ciprofloxacin resistancy._x000D_ _x000D_

Funding

The lubricant was provided and the microbiological examinations were sponsored by FarcoPharma.