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26.03.2021 | Original Article

Enhanced antibiotic prophylaxis and infection-related complications following prostate biopsy

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

Erschienen in: World Journal of Urology | Ausgabe 9/2021

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Abstract

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.

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Titel: Enhanced antibiotic prophylaxis and infection-related complications following prostate biopsy
verfasst von: Rebecca S. Steinberg
Lauren Kipling
K. C. Biebighauser Bens
Dattatraya Patil
Mark Henry
Akanksha Mehta
Christopher Filson
Publikationsdatum: 26.03.2021
Verlag: Springer Berlin Heidelberg
Erschienen in: World Journal of Urology / Ausgabe 9/2021
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-021-03674-w

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