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• W2105207699 abstract "No AccessJournal of UrologyAdult Urology1 Feb 2013Reduction in Hospital Admission Rates Due to Post-Prostate Biopsy Infections After Augmenting Standard Antibiotic Prophylaxis Mehrad Adibi, Brad Hornberger, Deepa Bhat, Ganesh Raj, Claus G. Roehrborn, and Yair Lotan Mehrad AdibiMehrad Adibi Nothing to disclose. More articles by this author , Brad HornbergerBrad Hornberger Financial interest and/or other relationship with Texas Academy of Physician Assistants and Urological Association of Physician Assistants. More articles by this author , Deepa BhatDeepa Bhat Nothing to disclose. More articles by this author , Ganesh RajGanesh Raj Financial interest and/or other relationship with Ptares, C-diagnostics Corp., Amgen and Johnson & Johnson. More articles by this author , Claus G. RoehrbornClaus G. Roehrborn Financial interest and/or other relationship with GlaxoSmithKline, VA Corporate Studies, Southwest Oncology Group, NIDDK, CALGB Clinical Trial Group, Lilly Icos, Urologix, AMS, Watson Pharmaceuticals, Protox, Neotract, Allergan, NERI and Afferent. More articles by this author , and Yair LotanYair Lotan Financial interest and/or other relationship with Alere, Abbott, Danone, Inverness and Endo. More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.08.194AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We evaluated the incidence of infectious complications requiring hospitalization after transrectal ultrasound guided prostate biopsy, comparing an augmented regimen of antibiotic prophylaxis to the standard regimen, and established cost-effectiveness at our center. Materials and Methods: Our standard antibiotic prophylaxis regimen consisted of 3 days of ciprofloxacin or Bactrim™ DS in the perioperative period. An increase in hospital admissions related to infection after transrectal ultrasound guided biopsy from January 2010 through December 2010 led us to initiate an augmented regimen of 3 days of ciprofloxacin or Bactrim DS in addition to 1 dose of intramuscular gentamicin before biopsy from January 2011 to December 2011. Urine and blood cultures along with bacterial susceptibilities were obtained at admission and compared between the 2 groups. Cost analysis was done to determine the cost-effectiveness of standard and augmented regimens. Results: The rate of hospitalization due to post-biopsy infections was 3.8% (11 patients among 290 biopsies) in 2010, which decreased to 0.6% (2 patients among 310 biopsies) in 2011 (p <0.001). Of the admitted patients who received standard prophylaxis, 73% had fluoroquinolone resistant Escherichia coli urinary infection and/or bacteremia and only 9% had strains resistant to gentamicin. Multivariate analysis showed that the standard regimen was significantly associated with hospital admission due to post-biopsy infection (HR 2.078 ± 0.84, p = 0.013). The augmented regimen resulted in a cost savings of $15,700 per 100 patients compared to the standard regimen. Conclusions: The addition of gentamicin to current prophylactic regimens significantly reduced the rate of hospitalization for post-biopsy infectious complications and was shown to be cost-effective. References 1 : Sepsis due to fluorquinolone-resistant Escherichia coli after transrectal ultrasound guided prostate needle biopsy. Urology2009; 74: 332. Google Scholar 2 : The incidence of fluoroquinolone resistant infections after prostate biopsy–are fluoroquinolones still effective prophylaxis?. J Urol2008; 179: 952. 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Link, Google Scholar University of Texas Southwestern Medical Center, Dallas, Texas© 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byLotan Y, Stovsky M, Rochelle R and Klein E (2020) Decision Analysis Model Comparing Cost of IsoPSA™ vs Repeat Biopsy for Detection of Clinically Significant Prostate Cancer in Men with Previous Negative Findings on BiopsyUrology Practice, VOL. 8, NO. 1, (40-46), Online publication date: 1-Jan-2021.Woldu S, Hutchinson R, Singla N, Hornberger B, Roehrborn C and Lotan Y (2017) Prospective Monitoring and Adapting Strategies for Prevention of Infection Following Transrectal Prostate ProceduresUrology Practice, VOL. 5, NO. 2, (124-131), Online publication date: 1-Mar-2018.Papagiannopoulos D, Abern M, Wilson N, O’Block N, Raff L, Coogan C and Latchamsetty K (2017) Predictors of Infectious Complications after Targeted Prophylaxis for Prostate Needle BiopsyJournal of Urology, VOL. 199, NO. 1, (155-160), Online publication date: 1-Jan-2018.Bloomfield M, Page M, McLachlan A, Studd R and Blackmore T (2017) Routine Ertapenem Prophylaxis for Transrectal Ultrasound Guided Prostate Biopsy does Not Select for Carbapenem Resistant Organisms: A Prospective Cohort StudyJournal of Urology, VOL. 198, NO. 2, (362-368), Online publication date: 1-Aug-2017.DiBianco J, Mullins J and Allaway M (2015) Ultrasound Guided, Freehand Transperineal Prostate Biopsy: An Alternative to the Transrectal ApproachUrology Practice, VOL. 3, NO. 2, (134-140), Online publication date: 1-Mar-2016.Womble P, Linsell S, Gao Y, Ye Z, Montie J, Gandhi T, Lane B, Burks F and Miller D (2015) A Statewide Intervention to Reduce Hospitalizations after Prostate BiopsyJournal of Urology, VOL. 194, NO. 2, (403-409), Online publication date: 1-Aug-2015.Farrell J, Salter C, Cullen J, Mordkin R and Joel A (2015) Culture Directed Antibiotic Prophylaxis Reduces Post-Prostate Biopsy Infectious Complications in the Community: A “How-to” for Urologists in the TrenchesUrology Practice, VOL. 2, NO. 4, (166-171), Online publication date: 1-Jul-2015.Liss M, Taylor S, Batura D, Steensels D, Chayakulkeeree M, Soenens C, Rao G, Dash A, Park S, Patel N, Woo J, McDonald M, Nseyo U, Banapour P, Unterberg S, Ahlering T, Van Poppel H, Sakamoto K, Fierer J and Black P (2014) Fluoroquinolone Resistant Rectal Colonization Predicts Risk of Infectious Complications after Transrectal Prostate BiopsyJournal of Urology, VOL. 192, NO. 6, (1673-1678), Online publication date: 1-Dec-2014.Womble P, Dixon M, Linsell S, Ye Z, Montie J, Lane B, Miller D and Burks F (2013) Infection Related Hospitalizations after Prostate Biopsy in a Statewide Quality Improvement CollaborativeJournal of Urology, VOL. 191, NO. 6, (1787-1792), Online publication date: 1-Jun-2014.Issa M, Al-Qassab U, Hall J, Ritenour C, Petros J and Sullivan J (2013) Formalin Disinfection of Biopsy Needle Minimizes the Risk of Sepsis Following Prostate BiopsyJournal of Urology, VOL. 190, NO. 5, (1769-1775), Online publication date: 1-Nov-2013.Gaylis F and Fink L (2013) Re: Combined Ciprofloxacin and Amikacin Prophylaxis in the Prevention of Septicemia after Transrectal Ultrasound Guided Biopsy of the ProstateJournal of Urology, VOL. 190, NO. 4, (1443-1444), Online publication date: 1-Oct-2013.Kehinde E (2013) Combined ciprofloxacin and amikacin prophylaxis in the prevention of septicaemia after transrectal ultrasound guided biopsy of the prostateJournal of Urology, Volume 189Issue 2February 2013Page: 535-540 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.Keywordsbiopsyprostateantibiotic prophylaxisinfectionMetricsAuthor Information Mehrad Adibi Nothing to disclose. More articles by this author Brad Hornberger Financial interest and/or other relationship with Texas Academy of Physician Assistants and Urological Association of Physician Assistants. More articles by this author Deepa Bhat Nothing to disclose. More articles by this author Ganesh Raj Financial interest and/or other relationship with Ptares, C-diagnostics Corp., Amgen and Johnson & Johnson. More articles by this author Claus G. Roehrborn Financial interest and/or other relationship with GlaxoSmithKline, VA Corporate Studies, Southwest Oncology Group, NIDDK, CALGB Clinical Trial Group, Lilly Icos, Urologix, AMS, Watson Pharmaceuticals, Protox, Neotract, Allergan, NERI and Afferent. More articles by this author Yair Lotan Financial interest and/or other relationship with Alere, Abbott, Danone, Inverness and Endo. More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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