Preprostate Biopsy Rectal Culture and Postbiopsy Sepsis

Urol Clin North Am. 2015 Nov;42(4):449-58. doi: 10.1016/j.ucl.2015.06.005. Epub 2015 Aug 8.

Abstract

Transrectal ultrasound-guided biopsy of the prostate (TRUSP) remains the primary procedure for the accurate histologic diagnosis of prostate cancer. Fluoroquinolones (FQs) are still recommended as the agents of choice for antimicrobial prophylaxis for TRUSP despite the alarming increasing incidence of FQ-resistant organisms among men undergoing TRUSP. This article reviews the current TRUSP antimicrobial prophylaxis guidelines, antimicrobial resistance and its implications for these guidelines, the incidence of post-TRUSP infectious complications including urosepsis, the seminal data supporting pre-TRUSP rectal swab (RS), RS technique and protocol, and the current available literature surrounding the efficacy of RS in reducing post-TRUSP infectious complications.

Keywords: Biopsy; Drug resistance; Prostate; Rectal swab; Targeted antimicrobial prophylaxis; Urosepsis.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use*
  • Antibiotic Prophylaxis / methods
  • Antibiotic Prophylaxis / standards*
  • Bacteremia / prevention & control
  • Colony Count, Microbial / standards
  • Endoscopic Ultrasound-Guided Fine Needle Aspiration / adverse effects*
  • Fluoroquinolones / therapeutic use*
  • Humans
  • Male
  • Practice Guidelines as Topic
  • Preoperative Care / methods
  • Preoperative Care / standards
  • Prostate / pathology*
  • Rectum / microbiology*
  • Urinary Tract Infections / prevention & control

Substances

  • Anti-Bacterial Agents
  • Fluoroquinolones