Poster, Podium & Video Sessions
Presentation Authors: Sophie Riddell*, Matthew Farag, John Daffy, Lih-Ming Wong, Melbourne, Australia
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.
Source Of Funding: none