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Targeted Prophylaxis Effective in Post-Prostate Biopsy Sepsis

Targeted prophylaxis similarly effective to empirical prophylaxis after transrectal prostate biopsy

TUESDAY, July 21, 2015 (HealthDay News) — For patients undergoing transrectal prostate biopsy, targeted prophylaxis is similarly effective to empirical prophylaxis for prevention of post-biopsy sepsis, according to a study published in the August issue of The Journal of Urology.

Michael A. Liss, M.D., from the University of Texas Health Science Center San Antonio, and colleagues compared the effectiveness of targeted prophylaxis with empirical prophylaxis for preventing sepsis after transrectal prostate biopsy. Rectal cultures were performed before transrectal prostate biopsy, and antibiotic sensitivities of Escherichia coli were used to guide antibiotic selection in the targeted prophylaxis group. Data were included for 5,355 prostate biopsy procedures; targeted prophylaxis was used in 34 percent and empirical prophylaxis in 66 percent of procedures.

The researchers found that post-biopsy sepsis incidence was 0.52 percent overall. The incidence of sepsis was 0.44 and 0.56 percent in the targeted prophylaxis and empirical prophylaxis groups, respectively (P = 0.568). On rectal culture, the prevalence of ciprofloxacin-resistant E. coli was 25 percent. Most patients on targeted prophylaxis in whom sepsis developed used a prophylactic antibiotic to which the sepsis-causing bacteria were sensitive (seven of eight cases).

“The targeted prophylaxis protocol enabled physicians to avoid using more than one broad-spectrum empirical antibiotic while simultaneously achieving an overall rate of sepsis similar to the rate seen with empirical prophylaxis,” the authors write.

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