Prostate Biopsy-related Infection: A Systematic Review of Risk Factors, Prevention Strategies, and Management Approaches

Urology. 2017 Jun;104:11-21. doi: 10.1016/j.urology.2016.12.011. Epub 2016 Dec 19.


A systematic review to identify risk factors for prostate biopsy-related infection, preventative strategies, and optimal management of infectious complications was conducted. Significant risk factors for postbiopsy infection include urogenital infection, antibiotic use, international travel, hospital exposure, bacteriuria, previous transrectal biopsy, and resistance of fecal flora to antibiotic prophylaxis (especially fluoroquinolones). Patients at risk may benefit from an adjusted biopsy protocol comprising transrectal biopsy under targeted prophylaxis, and/or the use of rectal disinfection techniques or using a transperineal approach. Management of biopsy-related infection should be based on individual risk and local resistance profiles with input from multiple specialties.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Adult
  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Antibiotic Prophylaxis
  • Bacteriuria / drug therapy
  • Bacteriuria / prevention & control
  • Biopsy / adverse effects*
  • Cross Infection / diagnosis
  • Drug Resistance, Bacterial
  • Fluoroquinolones / therapeutic use
  • Hospitalization
  • Humans
  • Male
  • Middle Aged
  • Patient Admission
  • Postoperative Complications / diagnosis*
  • Postoperative Complications / pathology*
  • Postoperative Complications / prevention & control*
  • Prostate / pathology
  • Prostatic Neoplasms / complications
  • Prostatic Neoplasms / diagnosis*
  • Prostatic Neoplasms / pathology*
  • Risk Factors
  • Travel


  • Anti-Bacterial Agents
  • Fluoroquinolones