Journal Article

The negative aftermath of prostate biopsy: prophylaxis, complications and antimicrobial stewardship: results of the global prevalence study of infections in urology 2010–2019

Medina-Polo, José, Cai Tommaso, Bruyère Franck, Alidjanov, Jakhongir F, Köves Béla, Pilatz Adrian, Naber, Kurt, Bartoletti Riccardo, Bonkat Gernot, Bjerklund Johansen Truls E, Perepanova Tamara, Wagenlehner, Florian M, Kulchavenya Ekaterina, Tandogdu Zafer

2021

Overview

PurposeTo evaluate and report the complications, and to analyse antimicrobial stewardship aspects following prostate biopsies (P-Bx) based on the data from a 9-year global study.MethodsThe primary outcome was to compare complications after P-Bx between patients of two cohorts: 2010–2014 and 2016–2019. Primary outcomes included symptoms of lower and severe/systemic urinary tract infection (LUTIS and SUTIS, respectively), and positive urine culture. Readmission to hospital after P-Bx, need for additional antimicrobial therapy, consumption of different antimicrobial agents for prophylaxis and therapy were evaluated. Students t test and chi-square test were used for comparative analyses. ResultsOutcome data were available for 1615 men. Fluoroquinolones-based prophylaxis rate increased from 72.0% in 2010–2014 to 78.6% in 2015–2019. Overall rates of complications increased from 6 to 11.7% including an increase in symptomatic complications from 4.7 to 10.2%, mainly due to an increase in LUTIS. Rates of patients seeking additional medical help in primary care after P-Bx increased from 7.4 to 14.4%; cases requiring post P-Bx antibiotic treatment increased from 6.1 to 9.7%, most of which received fluoroquinolones. Transperineal P-Bx was significantly associated with LUTIS. Following transrectal P-Bx, 2.8% developed febrile infections and 4.0% required hospitalisation. Two men (0.12%) died after transrectal P-Bx due to sepsis. ConclusionsThe rates of complications after P-Bx tended to increase in time, as well as rates of patients seeking additional medical help in the post-P-Bx period. To reduce the risk of infectious complications and to comply with the principles of antibiotic stewardship, clinicians should switch to the transperineal biopsy route.

• Publisher: Springer Nature B.V
• Subject: Antibiotics / Antimicrobial agents / Biopsy / Comparative analysis / Disease prevention / Fluoroquinolones / Patients / Prophylaxis / Prostate / Prostate cancer / Sepsis / Urinary tract / Urinary tract infections