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Current routines for antibiotic prophylaxis prior to transrectal prostate biopsy: a national survey to all urology clinics in Sweden
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Urology and Andrology.ORCID iD: 0000-0001-8455-2010
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Urology and Andrology.
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Urology and Andrology.
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2020 (English)In: F1000 Research, E-ISSN 2046-1402, Vol. 9, article id 58Article in journal (Refereed) Published
Abstract [en]

Background: The risk of infection after transrectal ultrasound (TRUS)-guided prostate biopsies is increasing. The aim of the study was to assess the use of antibiotic prophylaxis for prostate biopsy in Sweden. Methods: All public and private urology clinics reporting to the National Prostate Cancer Register of Sweden received a survey on TRUS-biopsy prophylaxis. Results: Of the 84 clinics surveyed, 76 replied (90%). If no risk factors for infection were present, a single dose of ciprofloxacin 750 mg was used by 50 clinics (66%). Multiple doses of ciprofloxacin 500 or 750 mg (n=14; 18%) or a single dose of trimethoprim-sulfamethoxazole 160/800 mg (n=7; 9%) were other common prophylaxes. Most clinics gave the prophylaxes immediately before the biopsy (n=41; 54%). Urine dipstick was used by 30 clinics (39%) and rectal enema by six (8%). In patients with high risk of infection, the survey mirrors a large variety of regiments used. Conclusions: The preference to use a single dose of ciprofloxacin 750 mg is in accordance with the Swedish national guidelines for patients with a low risk of infection. Better compliance to the guideline recommendation to use a urine dipstick would probably increase the number of patients classified as having an increased risk of infection. Being classified as a high-risk patient should lead to an extended duration of antibiotic prophylaxis, however, the variety of regimens used in the high-risk group reflects an inability to treat these patients in a standardized fashion and also highlights a need for more clear-cut guidelines. Pre-biopsy identification of high-risk patients is an important issue to tackle for the urologic clinics in order to reduce the number of infections.

Place, publisher, year, edition, pages
F1000 Research Ltd , 2020. Vol. 9, article id 58
Keywords [en]
Antibiotic prophylaxis, Prostate biopsy, Prostate cancer diagnostics, Survey
National Category
Urology and Nephrology
Identifiers
URN: urn:nbn:se:umu:diva-177380DOI: 10.12688/f1000research.19260.1PubMedID: 32399200Scopus ID: 2-s2.0-85084606058OAI: oai:DiVA.org:umu-177380DiVA, id: diva2:1507581
Available from: 2020-12-08 Created: 2020-12-08 Last updated: 2023-03-24Bibliographically approved

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Styrke, JohanLundström, Karl-Johan

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