Skip to main content

Advertisement

SpringerLink
Log in

Zero hospital admissions for infection after 577 transperineal prostate biopsies using single-dose cephazolin prophylaxis

  • Original Article
  • Published:
World Journal of Urology Aims and scope Submit manuscript

Abstract

Purpose

To determine the rate of hospital admissions for infection after transperineal biopsy of prostate (TPB) with single-dose cephazolin prophylaxis using a prospective database.

Method

Between April 2013 and February 2016, 577 patients undergoing TPB had 2 g of cephazolin given intravenously at induction of anaesthesia. Data collected from these patients included age, PSA, prostate volume, number of cores taken and post-operative complications.

Results

No patients were readmitted to hospital with infection post-TPB. Seven patients developed acute urinary retention, and one patient developed clinical prostatitis that was treated with oral antibiotics in the community.

Conclusion

It is safe to use single-dose cephazolin only as antibiotic prophylaxis prior to TPB, negating the need for quinolones. This study supports Australia’s current Therapeutic Guidelines recommendation for TPB prophylaxis and the existing evidence that sepsis post-TPB is a rare complication. Whether any antibiotic prophylaxis is needed at all for TPB is the subject of a future study.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Loeb S, Carter HB, Berndt SI et al (2011) Complications after prostate biopsy: data from SEER-medicare. J Urol 186(5):1830–1834

    Article  PubMed  Google Scholar 

  2. Davis P, Paul E, Grummet J (2015) Current practice of prostate biopsy in Australia and New Zealand: a survey. Urol Ann 7(3):315–319

    PubMed  PubMed Central  Google Scholar 

  3. Galfano A, Novara G, Iafrate M et al (2007) Prostate biopsy: the transperineal approach. http://eu-acme.org/europeanurology/upload_articles/Prostate%20Biopsy_The%20Transperineal%20Approach.pdf

  4. Mottet N, Bellmunt J, Briers E et al (2015) Guidelines on prostate cancer. http://uroweb.org/wp-content/uploads/09-Prostate-Cancer_LRV2-2015.pdf

  5. El-Hakim A, Moussa S (2010) CUA guidelines on prostate biopsy methodology. Can Urol Assoc J 4(2):89–94

    Article  PubMed  PubMed Central  Google Scholar 

  6. Nam RK, Saskin R, Lee Y et al (2013) Increasing hospital admission rates for urological complications after transrectal ultrasound guided prostate biopsy. J Urol 189(1 Suppl):S12–S17 (discussion S17–S18)

    Article  PubMed  Google Scholar 

  7. Wagenlehner FM, van Oostrum E, Tenke P et al (2013) Infective complications after prostate biopsy: outcome of the global prevalence study of infections in urology (GPIU) 2010 and 2011, a prospective multinational multicentre prostate biopsy study. Eur Urol 63(3):521–527

    Article  PubMed  Google Scholar 

  8. Zaytoun OM, Vargo EH, Rajan R et al (2011) Emergence of fluoroquinolone-resistant Escherichia coli as cause of postprostate biopsy infection: implications for prophylaxis and treatment. Urology 77(5):1035–1041

    Article  PubMed  Google Scholar 

  9. Grummet JP, Weerakoon M, Huang S et al (2014) Sepsis and ‘superbugs’: should we favour the transperineal over the transrectal approach for prostate biopsy? BJU Int 114(3):384–388

    PubMed  Google Scholar 

  10. Vyas L, Acher P, Kinsella J et al (2014) Indications, results and safety profile of transperineal sector biopsies (TPSB) of the prostate: a single centre experience of 634 cases. BJU Int 114(1):32–37

    Article  PubMed  Google Scholar 

  11. Pepe P, Aragona F (2013) Morbidity after transperineal prostate biopsy in 3000 patients undergoing 12 vs 18 vs more than 24 needle cores. Urology 81(6):1142–1146

    Article  PubMed  Google Scholar 

  12. Suzuki M, Kawakami S, Asano T et al (2009) Safety of transperineal 14-core systematic prostate biopsy in diabetic men. Int J Urol 16(12):930–935

    Article  PubMed  Google Scholar 

  13. Transperineal prostatic biopsy (2015) Therapeutic guidelines. http://online.tg.org.au/ip/desktop/index.htm

  14. Wolf JS Jr, Bennett CJ, Dmochowski RR et al (2008) Best practice policy statement on urologic surgery antimicrobial prophylaxis. J Urol 179(4):1379–1390

    Article  PubMed  Google Scholar 

  15. Lee G, Attar K, Laniado M et al (2007) Trans-rectal ultrasound guided biopsy of the prostate: nationwide diversity in practice and training in the United Kingdom. Int Urol Nephrol 39(1):185–188

    Article  PubMed  Google Scholar 

  16. Raaijmakers R, Kirkels WJ, Roobol MJ et al (2002) Complication rates and risk factors of 5802 transrectal ultrasound-guided sextant biopsies of the prostate within a population-based screening program. Urology 60(5):826–830

    Article  PubMed  Google Scholar 

  17. Drew RJ, Turton JF, Hill RL et al (2013) Emergence of carbapenem-resistant enterobacteriaceae in a UK paediatric hospital. J Hosp Infect 84(4):300–304

    Article  CAS  PubMed  Google Scholar 

  18. Kotsanas D, Wijesooriya WR, Korman TM et al (2013) “Down the drain”: carbapenem-resistant bacteria in intensive care unit patients and handwashing sinks. Med J Aust 198(5):267–269

    Article  PubMed  Google Scholar 

  19. Cuevas O, Oteo J, Lazaro E et al (2011) Significant ecological impact on the progression of fluoroquinolone resistance in Escherichia coli with increased community use of moxifloxacin, levofloxacin and amoxicillin/clavulanic acid. J Antimicrob Chemother 66(3):664–669

    Article  CAS  PubMed  Google Scholar 

  20. Taylor S, Margolick J, Abughosh Z et al (2013) Ciprofloxacin resistance in the faecal carriage of patients undergoing transrectal ultrasound guided prostate biopsy. BJU Int 111(6):946–953

    Article  CAS  PubMed  Google Scholar 

  21. Leahy OR, O’Reilly M, Dyer DR et al (2014) Transrectal ultrasound-guided biopsy sepsis and the rise in carbapenem antibiotic use. ANZ J Surg. doi:10.1111/ans.12933

    PubMed  Google Scholar 

  22. Borer A, Gilad J, Sikuler E et al (1999) Fatal Clostridium sordellii ischio-rectal abscess with septicaemia complicating ultrasound-guided transrectal prostate biopsy. J Infect 38(2):128–129

    Article  CAS  PubMed  Google Scholar 

  23. Brewster SF, Rooney N, Kabala J et al (1993) Fatal anaerobic infection following transrectal biopsy of a rare prostatic tumor. Br J Urol 72(6):977–978

    Article  CAS  PubMed  Google Scholar 

  24. Grabe M, Bartoletti R, Bjerklund-Johansen TE et al (2015) Guidelines on urological infections. http://uroweb.org/wp-content/uploads/19-Urological-infections_LR.pdf

Download references

Acknowledgements

Funding was provided by Ipsen.

Authors’ contributions

LP and GT were involved in the data management, data analysis and manuscript writing/editing; SH and SM were involved in the data management; MF, DM, UH, AL and RS were involved in the data collection; JG was involved in the protocol development and manuscript writing/editing.

Author information

Authors and Affiliations

  1. Australian Urology Associates, Melbourne, VIC, Australia

    Lana Pepdjonovic, Sean Huang, Sarah Mann, Mark Frydenberg, Daniel Moon, Uri Hanegbi, Adam Landau, Ross Snow & Jeremy Grummet

  2. Urology Unit, Department of Surgery, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia

    Guan Hee Tan

  3. Department of Urology, Alfred Health, Melbourne, VIC, Australia

    Guan Hee Tan & Jeremy Grummet

  4. Department of Surgery, Monash University, Melbourne, VIC, Australia

    Mark Frydenberg & Jeremy Grummet

Authors
  1. Lana Pepdjonovic
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Guan Hee Tan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sean Huang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sarah Mann
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mark Frydenberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Daniel Moon
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Uri Hanegbi
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Adam Landau
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Ross Snow
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Jeremy Grummet
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lana Pepdjonovic.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Pepdjonovic, L., Tan, G.H., Huang, S. et al. Zero hospital admissions for infection after 577 transperineal prostate biopsies using single-dose cephazolin prophylaxis. World J Urol 35, 1199–1203 (2017). https://doi.org/10.1007/s00345-016-1985-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00345-016-1985-1

Keywords

Search

Navigation