Fosfomycin for Antibiotic Prophylaxis in Men Undergoing a Transrectal Prostate Biopsy: A Systematic Review and Meta-Analysis
<i>Background and Objectives:</i> To assess the effects of fosfomycin compared with other antibiotics as a prophylaxis for urinary tract infections (UTIs) in men undergoing transrectal prostate biopsies. <i>Materials and Methods:</i> We searched multiple databases and trial r...
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MDPI AG
2023-05-01
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| Online Access: | https://www.mdpi.com/1648-9144/59/5/911 |
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| author | Hui Mo Gu Jin Seok Gu Ho Seok Chung Seung Il Jung Dongdeuk Kwon Myung Ha Kim Jae Hung Jung Mi Ah Han Seung Ji Kang Eu Chang Hwang Philipp Dahm |
| author_facet | Hui Mo Gu Jin Seok Gu Ho Seok Chung Seung Il Jung Dongdeuk Kwon Myung Ha Kim Jae Hung Jung Mi Ah Han Seung Ji Kang Eu Chang Hwang Philipp Dahm |
| author_sort | Hui Mo Gu |
| collection | DOAJ |
| description | <i>Background and Objectives:</i> To assess the effects of fosfomycin compared with other antibiotics as a prophylaxis for urinary tract infections (UTIs) in men undergoing transrectal prostate biopsies. <i>Materials and Methods:</i> We searched multiple databases and trial registries without publication language or status restrictions until 4 January 2022. Parallel-group randomized controlled trials (RCTs) and non-randomized studies (NRS) were included. The primary outcomes were febrile UTI, afebrile UTI, and overall UTI. We used GRADE guidance to rate the certainty of evidence of RCTs and NRSs. The protocol was registered with PROSPERO (CRD42022302743). <i>Results:</i> We found data on five comparisons; however, this abstract focuses on the primary outcomes of the two most clinically relevant comparisons. Regarding fosfomycin versus fluoroquinolone, five RCTs and four NRSs with a one-month follow-up were included. Based on the RCT evidence, fosfomycin likely resulted in little to no difference in febrile UTIs compared with fluoroquinolone. This difference corresponded to four fewer febrile UTIs per 1000 patients. Fosfomycin likely resulted in little to no difference in afebrile UTIs compared with fluoroquinolone. This difference corresponded to 29 fewer afebrile UTIs per 1000 patients. Fosfomycin likely resulted in little to no difference in overall UTIs compared with fluoroquinolone. This difference corresponded to 35 fewer overall UTIs per 1000 patients. Regarding fosfomycin and fluoroquinolone combined versus fluoroquinolone, two NRSs with a one- to three-month follow-up were included. Based on the NRS evidence, fosfomycin and fluoroquinolone combined may result in little to no difference in febrile UTIs compared with fluoroquinolone. This difference corresponded to 16 fewer febrile UTIs per 1000 patients. <i>Conclusions:</i> Compared with fluoroquinolone, fosfomycin or fosfomycin and fluoroquinolone combined may have a similar prophylactic effect on UTIs after a transrectal prostate biopsy. Given the increasing fluoroquinolone resistance and its ease to use, fosfomycin may be a good option for antibiotic prophylaxis. |
| first_indexed | 2024-03-11T03:31:16Z |
| format | Article |
| id | doaj.art-5ee2c8c47c114c249856fbec70edaf69 |
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| language | English |
| last_indexed | 2024-03-11T03:31:16Z |
| publishDate | 2023-05-01 |
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| spelling | doaj.art-5ee2c8c47c114c249856fbec70edaf692023-11-18T02:22:08ZengMDPI AGMedicina1010-660X1648-91442023-05-0159591110.3390/medicina59050911Fosfomycin for Antibiotic Prophylaxis in Men Undergoing a Transrectal Prostate Biopsy: A Systematic Review and Meta-AnalysisHui Mo Gu0Jin Seok Gu1Ho Seok Chung2Seung Il Jung3Dongdeuk Kwon4Myung Ha Kim5Jae Hung Jung6Mi Ah Han7Seung Ji Kang8Eu Chang Hwang9Philipp Dahm10Department of Urology, Chonnam National University Medical School, Hwasun 58128, Republic of KoreaDepartment of Urology, Chonnam National University Medical School, Hwasun 58128, Republic of KoreaDepartment of Urology, Chonnam National University Medical School, Hwasun 58128, Republic of KoreaDepartment of Urology, Chonnam National University Medical School, Hwasun 58128, Republic of KoreaDepartment of Urology, Chonnam National University Medical School, Hwasun 58128, Republic of KoreaYonsei Wonju Medical Library, Yonsei University Wonju College of Medicine, Wonju 26426, Republic of KoreaDepartment of Urology, Yonsei University Wonju College of Medicine, Wonju 26426, Republic of KoreaDepartment of Preventive Medicine, College of Medicine, Chosun University, Gwangju 61452, Republic of KoreaDepartment of Infectious Disease, Chonnam National University Medical School, Gwangju 61469, Republic of KoreaDepartment of Urology, Chonnam National University Medical School, Hwasun 58128, Republic of KoreaDepartment of Urology, University of Minnesota, Minneapolis, MN 55455, USA<i>Background and Objectives:</i> To assess the effects of fosfomycin compared with other antibiotics as a prophylaxis for urinary tract infections (UTIs) in men undergoing transrectal prostate biopsies. <i>Materials and Methods:</i> We searched multiple databases and trial registries without publication language or status restrictions until 4 January 2022. Parallel-group randomized controlled trials (RCTs) and non-randomized studies (NRS) were included. The primary outcomes were febrile UTI, afebrile UTI, and overall UTI. We used GRADE guidance to rate the certainty of evidence of RCTs and NRSs. The protocol was registered with PROSPERO (CRD42022302743). <i>Results:</i> We found data on five comparisons; however, this abstract focuses on the primary outcomes of the two most clinically relevant comparisons. Regarding fosfomycin versus fluoroquinolone, five RCTs and four NRSs with a one-month follow-up were included. Based on the RCT evidence, fosfomycin likely resulted in little to no difference in febrile UTIs compared with fluoroquinolone. This difference corresponded to four fewer febrile UTIs per 1000 patients. Fosfomycin likely resulted in little to no difference in afebrile UTIs compared with fluoroquinolone. This difference corresponded to 29 fewer afebrile UTIs per 1000 patients. Fosfomycin likely resulted in little to no difference in overall UTIs compared with fluoroquinolone. This difference corresponded to 35 fewer overall UTIs per 1000 patients. Regarding fosfomycin and fluoroquinolone combined versus fluoroquinolone, two NRSs with a one- to three-month follow-up were included. Based on the NRS evidence, fosfomycin and fluoroquinolone combined may result in little to no difference in febrile UTIs compared with fluoroquinolone. This difference corresponded to 16 fewer febrile UTIs per 1000 patients. <i>Conclusions:</i> Compared with fluoroquinolone, fosfomycin or fosfomycin and fluoroquinolone combined may have a similar prophylactic effect on UTIs after a transrectal prostate biopsy. Given the increasing fluoroquinolone resistance and its ease to use, fosfomycin may be a good option for antibiotic prophylaxis.https://www.mdpi.com/1648-9144/59/5/911fosfomycinurinary tract infectionsprostatebiopsy |
| spellingShingle | Hui Mo Gu Jin Seok Gu Ho Seok Chung Seung Il Jung Dongdeuk Kwon Myung Ha Kim Jae Hung Jung Mi Ah Han Seung Ji Kang Eu Chang Hwang Philipp Dahm Fosfomycin for Antibiotic Prophylaxis in Men Undergoing a Transrectal Prostate Biopsy: A Systematic Review and Meta-Analysis Medicina fosfomycin urinary tract infections prostate biopsy |
| title | Fosfomycin for Antibiotic Prophylaxis in Men Undergoing a Transrectal Prostate Biopsy: A Systematic Review and Meta-Analysis |
| title_full | Fosfomycin for Antibiotic Prophylaxis in Men Undergoing a Transrectal Prostate Biopsy: A Systematic Review and Meta-Analysis |
| title_fullStr | Fosfomycin for Antibiotic Prophylaxis in Men Undergoing a Transrectal Prostate Biopsy: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Fosfomycin for Antibiotic Prophylaxis in Men Undergoing a Transrectal Prostate Biopsy: A Systematic Review and Meta-Analysis |
| title_short | Fosfomycin for Antibiotic Prophylaxis in Men Undergoing a Transrectal Prostate Biopsy: A Systematic Review and Meta-Analysis |
| title_sort | fosfomycin for antibiotic prophylaxis in men undergoing a transrectal prostate biopsy a systematic review and meta analysis |
| topic | fosfomycin urinary tract infections prostate biopsy |
| url | https://www.mdpi.com/1648-9144/59/5/911 |
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