Is Routine Antibiotic Prophylaxis Required For Transperineal Prostate Biopsy?

Document Type

Conference Proceeding

Publication Date

4-2023

Publication Title

Journal of Urology

Abstract

INTRODUCTION AND OBJECTIVE: Transperineal prostate biopsy (TPBx) has successfully reduced the risk of infectious complications compared to the transrectal approach. Contemporary guidelines continue to recommend antibiotic prophylaxis due to potential rectal/skin flora contamination or entry into the urinary tract; however, this inherently risks escalating antimicrobial resistance. We sought to evaluate the current practice patterns of antibiotic prophylaxis (ATB) for TPBx and the associated rates of infectious complications. METHODS: Men in the Michigan Urological Surgery Improvement Collaborative (MUSIC) prostate cancer registry who underwent non-fusion (systematic) TPBx between 2017 and 2022 were analyzed. Patient demographics, disease characteristics, and peri-procedural outcomes were assessed. The primary outcome was infectious complications after TPBx. Infections were defined as fever, sepsis, and/or UTI. RESULTS: We identified 2212 men who underwent non-fusion (systematic) TPBx in the study period, 669 (30%) of whom did not receive ATB for TPBx (Table 1). The yearly percentage of patients with no ATB rose from 0.81% in 2017 to 65.6% in 2022 (Figure 1). Between patients with ATB and no ATB, there were no statistically significant difference in rates of infection (0.65% vs 0.45%, p=0.77)or infectious hospitalizations (0.32% vs 0.45%, p=0.70).CONCLUSIONS: Use of antibiotic prophylaxis for TPBx has decreased over time in the state of Michigan. Antibiotic prophylaxis was not associated with rates of infection and infectious hospitalizations after transperineal fusion biopsy

Volume

209

Issue

4S

First Page

e994

Last Page

e995

Comments

American Urological Association Annual Meeting, April 28 - May 1, 2023, Chicago, IL

DOI

10.1097/JU.0000000000003336.05

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