Details

Autor(en) / Beteiligte

• Steinberg, Rebecca S.
• Kipling, Lauren
• Bens, K. C. Biebighauser
• Patil, Dattatraya
• Henry, Mark
• Mehta, Akanksha
• Filson, Christopher

Titel

Enhanced antibiotic prophylaxis and infection-related complications following prostate biopsy

Ist Teil von

• World journal of urology, 2021-09, Vol.39 (9), p.3415-3422

Ort / Verlag

Berlin/Heidelberg: Springer Berlin Heidelberg

Erscheinungsjahr

2021

Quelle

MEDLINE

Beschreibungen/Notizen

• Purpose Sepsis after prostate biopsy is a costly and potentially lethal complication. We sought to assess whether enhanced antibiotic prophylaxis regimens combining oral and parenteral antibiotics may decrease the risk of post-biopsy urinary tract infection and sepsis compared to regimens with only oral antibiotics. Methods We identified men with commercial insurance who underwent prostate biopsy (2009–2015) with prophylactic antibiotic coverage. Our primary exposure of interest was antibiotic regimen: enhanced, oral-only, and parenteral-only. Post-biopsy outcomes of interest included urinary tract infections and sepsis/bacteremia after prostate biopsy. We used bivariate testing to assess associations between outcomes, exposures, and other covariates of interest. Multivariable regression was used to estimate adjusted odds of infectious outcomes based on antibiotic regimen. Results We identified 163,831 men who underwent prostate biopsy. The proportion of men with infectious complications (5.5% in 2009 to 6.9% in 2015, p  < 0.001) and sepsis (0.24% in 2009 to 0.30% in 2015, p  = 0.327) increased over the timeframe of our analysis. Use of fluoroquinolones was associated with a decreased risk of infectious outcomes (5.8 vs 7.3% without, OR 0.83, 95% CI 0.79–0.88). Use of enhanced antibiotic regimens was associated with an increased risk of infectious outcomes (6.8 vs 5.7% oral, OR 1.23, 95% CI 1.16–1.31) and sepsis (0.34 vs 0.24% oral, OR 1.40, 95% CI 1.08–1.82) among our cohort. Conclusion We did not observe a significant reduction in infectious complications among men who received enhanced antibiotics regimens before prostate biopsy. This may be due to increased antibiotic resistance or unmeasured risk factors among those receiving enhanced regimens.