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Short-term ciprofloxacin prophylaxis for prostate biopsy and risk of aortic aneurysm: nationwide, population-based cohort study
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Urology and Andrology.
Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, Guy's Hospital, London, United Kingdom; Regional Cancer Center Uppsala Örebro, Uppsala University Hospital, Uppsala, Sweden; Department of Surgical Sciences, Urology, Uppsala University, Uppsala, Sweden.
Department of Surgical Sciences, Anesthesiology and Intensive Care, Uppsala University, Uppsala, Sweden.
Department of Surgical Sciences, Urology, Uppsala University, Uppsala, Sweden.
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2021 (English)In: Scandinavian journal of urology, ISSN 2168-1805, E-ISSN 2168-1813, Vol. 55, no 3, p. 221-226Article in journal (Refereed) Published
Abstract [en]

Introduction: The use of quinolones has recently been questioned due to reports on side effects including an increased risk of aortic aneurysm. The aim of the study was to examine the risk of aortic aneurysm (AA) after short-term ciprofloxacin as prophylaxis for prostate biopsy.

Materials and Methods: We used the Prostate Cancer data Base Sweden and investigated 192,024 prostate biopsy exposures vs. 554,974 non-exposures for risk of AA. Prostate biopsy was used as a proxy for quinolone use as short-term ciprofloxacin is the recommended and documented prophylaxis in Sweden for this procedure. The outcome was the hazard ratio (HR) of AA in men who underwent a biopsy vs. those that did not.

Results: The absolute risk of AA was small, 39/10,000 person years for all AÁs and for ruptured AÁs 3.5/10,000 person years. In multivariate analyses, there were small, non-significant increases in risk of all AA’s (adjusted HR = 1.13, 95% CI: 0.91 to 1.39) and ruptured AÁs (adjusted HR = 1.05, 95% CI: 0.52 to 2.15) in men who underwent biopsy. A significantly increased risk of AA was observed in men diagnosed with high-risk prostate cancer on biopsy (HR = 1.50, 95% CI: 1.15–2.21). The use of prostate biopsy as a proxy for exposure to ciprofloxacin was a limitation of the study.

Conclusions: Short-term ciprofloxacin was not associated with an increased risk of aortic aneurysm and the increased risk in men with high-risk prostate cancer was likely due detection bias caused by imaging more commonly performed in these men.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2021. Vol. 55, no 3, p. 221-226
Keywords [en]
aortic aneurysm, ciprofloxacin, prophylaxis, Prostate biopsy
National Category
Urology and Nephrology
Identifiers
URN: urn:nbn:se:umu:diva-183575DOI: 10.1080/21681805.2021.1916072ISI: 000667306600001PubMedID: 33908321Scopus ID: 2-s2.0-85105230378OAI: oai:DiVA.org:umu-183575DiVA, id: diva2:1559577
Funder
Swedish Research Council, 2017-00847Available from: 2021-06-02 Created: 2021-06-02 Last updated: 2022-01-12Bibliographically approved

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Lundström, Karl-JohanStattin, PärStyrke, Johan

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