Efficacy of fosfomycin compared to second generation cephalosporin flumarin as antimicrobial prophylaxis for transrectal ultrasound-guided prostate biopsy: a single center retrospective study
Abstract Background Fluoroquinolone has been the historic choice of antimicrobial prophylaxis for transrectal ultrasound (TRUS) guided prostate biopsy. However, increased fluoroquinolone resistance and recent restrictions of its use for antimicrobial prophylaxis has led to the emergence of alternati...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-12-01
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| Series: | BMC Urology |
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| Online Access: | https://doi.org/10.1186/s12894-023-01391-7 |
| _version_ | 1797376800312000512 |
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| author | Hee Youn Kim Daehyun Lim Young Hyo Choi Je Mo Yoo Dong Sup Lee Seung-Ju Lee |
| author_facet | Hee Youn Kim Daehyun Lim Young Hyo Choi Je Mo Yoo Dong Sup Lee Seung-Ju Lee |
| author_sort | Hee Youn Kim |
| collection | DOAJ |
| description | Abstract Background Fluoroquinolone has been the historic choice of antimicrobial prophylaxis for transrectal ultrasound (TRUS) guided prostate biopsy. However, increased fluoroquinolone resistance and recent restrictions of its use for antimicrobial prophylaxis has led to the emergence of alternative agents for antimicrobial prophylaxis for TRUS guided prostate biopsy including fosfomycin and cephalosporins. This study aimed to compare the efficacy of fosfomycin and a second-generation cephalosporin flumarin as alternative antimicrobials for TRUS-guided prostate biopsy in terms of the incidence of infectious complications after TRUS-guided prostate biopsy. Methods A retrospective chart review of all patients who underwent TRUS-guided prostate biopsy between November 2009 to January 2023 was undertaken. Comparison of baseline characteristics and the incidence of infectious complications was done between those who received fosfomycin as antimicrobial prophylaxis for TRUS-guided prostate biopsy and those who received flumarin. Multivariate logistic regression analysis was conducted to identify risk factors for infectious complications after TRUS-guided prostate biopsy. Results Of 2,900 patients identified as eligible candidates for analysis, 333 (11.5%) received fosfomycin and 2,567 (88.5%) received flumarin. The overall rate of infectious complications was approximately 3% lower in patients who received fosfomycin, although such difference did not reach statistical significance (5.7% vs. 8.6%, p = 0.074). Multivariate logistic regression analysis showed that history of operation done under general anaesthesia within six months of the biopsy (odds ratio [OR]: 2.216; 95% confidence interval [CI]: 1.042–4.713; p = 0.039) and history of prior antimicrobial use within six months (OR: 1.457; 95% CI: 1.049–2.024; p = 0.025) were significant risk factors for infectious complications after TRUS-guided prostate biopsy. Conclusion Fosfomycin was comparable to second-generation cephalosporin flumarin in preventing infectious complications after TRUS-guided prostate biopsy. Coupled with its properties such as ease of administration, low adverse effects, low resistance rate, and low collateral damage, fosfomycin might be an attractive alternative antimicrobial prophylaxis for TRUS-guided prostate biopsy. |
| first_indexed | 2024-03-08T19:43:49Z |
| format | Article |
| id | doaj.art-c630413f93e24a11927cc4c4155d0017 |
| institution | Directory Open Access Journal |
| issn | 1471-2490 |
| language | English |
| last_indexed | 2024-03-08T19:43:49Z |
| publishDate | 2023-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Urology |
| spelling | doaj.art-c630413f93e24a11927cc4c4155d00172023-12-24T12:30:14ZengBMCBMC Urology1471-24902023-12-012311710.1186/s12894-023-01391-7Efficacy of fosfomycin compared to second generation cephalosporin flumarin as antimicrobial prophylaxis for transrectal ultrasound-guided prostate biopsy: a single center retrospective studyHee Youn Kim0Daehyun Lim1Young Hyo Choi2Je Mo Yoo3Dong Sup Lee4Seung-Ju Lee5Department of Urology, College of Medicine, St. Vincent’s Hospital, The Catholic University of KoreaDepartment of Urology, College of Medicine, St. Vincent’s Hospital, The Catholic University of KoreaDepartment of Urology, College of Medicine, St. Vincent’s Hospital, The Catholic University of KoreaDepartment of Urology, College of Medicine, St. Vincent’s Hospital, The Catholic University of KoreaDepartment of Urology, College of Medicine, St. Vincent’s Hospital, The Catholic University of KoreaDepartment of Urology, College of Medicine, St. Vincent’s Hospital, The Catholic University of KoreaAbstract Background Fluoroquinolone has been the historic choice of antimicrobial prophylaxis for transrectal ultrasound (TRUS) guided prostate biopsy. However, increased fluoroquinolone resistance and recent restrictions of its use for antimicrobial prophylaxis has led to the emergence of alternative agents for antimicrobial prophylaxis for TRUS guided prostate biopsy including fosfomycin and cephalosporins. This study aimed to compare the efficacy of fosfomycin and a second-generation cephalosporin flumarin as alternative antimicrobials for TRUS-guided prostate biopsy in terms of the incidence of infectious complications after TRUS-guided prostate biopsy. Methods A retrospective chart review of all patients who underwent TRUS-guided prostate biopsy between November 2009 to January 2023 was undertaken. Comparison of baseline characteristics and the incidence of infectious complications was done between those who received fosfomycin as antimicrobial prophylaxis for TRUS-guided prostate biopsy and those who received flumarin. Multivariate logistic regression analysis was conducted to identify risk factors for infectious complications after TRUS-guided prostate biopsy. Results Of 2,900 patients identified as eligible candidates for analysis, 333 (11.5%) received fosfomycin and 2,567 (88.5%) received flumarin. The overall rate of infectious complications was approximately 3% lower in patients who received fosfomycin, although such difference did not reach statistical significance (5.7% vs. 8.6%, p = 0.074). Multivariate logistic regression analysis showed that history of operation done under general anaesthesia within six months of the biopsy (odds ratio [OR]: 2.216; 95% confidence interval [CI]: 1.042–4.713; p = 0.039) and history of prior antimicrobial use within six months (OR: 1.457; 95% CI: 1.049–2.024; p = 0.025) were significant risk factors for infectious complications after TRUS-guided prostate biopsy. Conclusion Fosfomycin was comparable to second-generation cephalosporin flumarin in preventing infectious complications after TRUS-guided prostate biopsy. Coupled with its properties such as ease of administration, low adverse effects, low resistance rate, and low collateral damage, fosfomycin might be an attractive alternative antimicrobial prophylaxis for TRUS-guided prostate biopsy.https://doi.org/10.1186/s12894-023-01391-7Prostatic neoplasmsImage-guided biopsyAntibiotic prophylaxis |
| spellingShingle | Hee Youn Kim Daehyun Lim Young Hyo Choi Je Mo Yoo Dong Sup Lee Seung-Ju Lee Efficacy of fosfomycin compared to second generation cephalosporin flumarin as antimicrobial prophylaxis for transrectal ultrasound-guided prostate biopsy: a single center retrospective study BMC Urology Prostatic neoplasms Image-guided biopsy Antibiotic prophylaxis |
| title | Efficacy of fosfomycin compared to second generation cephalosporin flumarin as antimicrobial prophylaxis for transrectal ultrasound-guided prostate biopsy: a single center retrospective study |
| title_full | Efficacy of fosfomycin compared to second generation cephalosporin flumarin as antimicrobial prophylaxis for transrectal ultrasound-guided prostate biopsy: a single center retrospective study |
| title_fullStr | Efficacy of fosfomycin compared to second generation cephalosporin flumarin as antimicrobial prophylaxis for transrectal ultrasound-guided prostate biopsy: a single center retrospective study |
| title_full_unstemmed | Efficacy of fosfomycin compared to second generation cephalosporin flumarin as antimicrobial prophylaxis for transrectal ultrasound-guided prostate biopsy: a single center retrospective study |
| title_short | Efficacy of fosfomycin compared to second generation cephalosporin flumarin as antimicrobial prophylaxis for transrectal ultrasound-guided prostate biopsy: a single center retrospective study |
| title_sort | efficacy of fosfomycin compared to second generation cephalosporin flumarin as antimicrobial prophylaxis for transrectal ultrasound guided prostate biopsy a single center retrospective study |
| topic | Prostatic neoplasms Image-guided biopsy Antibiotic prophylaxis |
| url | https://doi.org/10.1186/s12894-023-01391-7 |
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