Comparison of Complication Rates with Antibiotic Prophylaxis with Cefpodoxime Versus Fluoroquinolones After Transrectal Prostate Biopsy
After recommended restriction of the use of fluoroquinolones, the optimal antibiotic prophylaxis for transrectal prostate biopsy is still under debate. To test the effectiveness of cefpodoxime as oral antibiotic prophylaxis for transrectal prostate biopsies and the complication rates relative to flu...
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| Veröffentlicht in: | European urology focus 2021-09, Vol.7 (5), p.980-986 |
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| creator | Wenzel, Mike Welte, Maria N. Theissen, Lena H. Wittler, Clarissa Hoeh, Benedikt Humke, Clara Preisser, Felix Würnschimmel, Christoph Tilki, Derya Graefen, Markus Roos, Frederik C. Becker, Andreas Karakiewicz, Pierre I. Chun, Felix K.H. Kluth, Luis A. Mandel, Philipp |
| description | After recommended restriction of the use of fluoroquinolones, the optimal antibiotic prophylaxis for transrectal prostate biopsy is still under debate.
To test the effectiveness of cefpodoxime as oral antibiotic prophylaxis for transrectal prostate biopsies and the complication rates relative to fluoroquinolones.
Antibiotic prophylaxis for transrectal prostate biopsies at the Department of Urology at University Hospital Frankfurt was fluoroquinolones for 342 consecutive patients in January 2018 and December 2019 and cefpodoxime for 100 patients from January 2020 to July 2020. Data were prospectively evaluated and retrospectively analyzed. Patients were followed up according to clinical routine at 6 wk after biopsy at the earliest. Patients without follow-up (n = 98) and those receiving antibiotic prophylaxis other than cefpodoxime or fluoroquinolones (n = 15) were excluded.
Use of cefpodoxime or fluoroquinolones as antibiotic prophylaxis for transrectal prostate biopsies.
Logistic regression models were used to predict biopsy-related complications according to antibiotic prophylaxis.
Of 442 patients, 100 (22.6%) received cefpodoxime as antibiotic prophylaxis. Patient baseline and biopsy characteristics were comparable between the cefpodoxime and fluoroquinolone groups. Moreover, there were no differences in the number of prior prostate biopsies or the proportions of systematic vs. fusion biopsies (p > 0.05). There were no differences between the groups in infectious complications such as epididymitis and prostatitis after biopsy. Infectious complication rates were very low, at 2.0% in the cefpodoxime and0.9%fluoroquinolone group. Moreover, there were no differences between the groups in patient-reported complications, such as gross hematuria occurring at more than 5 d after biopsy, hematospermia, or rectal bleeding. In multivariable analyses, after adjustment for patient and prostate biopsy characteristics, cefpodoxime was not associated with higher complication rates than fluoroquinolones (p > 0.05).
Complications after transrectal prostate biopsies are rare and cefpodoxime might be a sufficient choice as oral antibiotic prophylaxis and noninferior compared to fluoroquinolones.
Cefpodoxime might be a sufficient choice as an easily applicable oral antibiotic prophylaxis for transrectal prostate biopsy. The safety profile of cefpodoxime is comparable to the safety profile of fluoroquinolones.
Cefpodoxime, a relatively new third-generation oral cephalosporin |
| doi_str_mv | 10.1016/j.euf.2020.11.006 |
| format | Article |
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To test the effectiveness of cefpodoxime as oral antibiotic prophylaxis for transrectal prostate biopsies and the complication rates relative to fluoroquinolones.
Antibiotic prophylaxis for transrectal prostate biopsies at the Department of Urology at University Hospital Frankfurt was fluoroquinolones for 342 consecutive patients in January 2018 and December 2019 and cefpodoxime for 100 patients from January 2020 to July 2020. Data were prospectively evaluated and retrospectively analyzed. Patients were followed up according to clinical routine at 6 wk after biopsy at the earliest. Patients without follow-up (n = 98) and those receiving antibiotic prophylaxis other than cefpodoxime or fluoroquinolones (n = 15) were excluded.
Use of cefpodoxime or fluoroquinolones as antibiotic prophylaxis for transrectal prostate biopsies.
Logistic regression models were used to predict biopsy-related complications according to antibiotic prophylaxis.
Of 442 patients, 100 (22.6%) received cefpodoxime as antibiotic prophylaxis. Patient baseline and biopsy characteristics were comparable between the cefpodoxime and fluoroquinolone groups. Moreover, there were no differences in the number of prior prostate biopsies or the proportions of systematic vs. fusion biopsies (p > 0.05). There were no differences between the groups in infectious complications such as epididymitis and prostatitis after biopsy. Infectious complication rates were very low, at 2.0% in the cefpodoxime and0.9%fluoroquinolone group. Moreover, there were no differences between the groups in patient-reported complications, such as gross hematuria occurring at more than 5 d after biopsy, hematospermia, or rectal bleeding. In multivariable analyses, after adjustment for patient and prostate biopsy characteristics, cefpodoxime was not associated with higher complication rates than fluoroquinolones (p > 0.05).
Complications after transrectal prostate biopsies are rare and cefpodoxime might be a sufficient choice as oral antibiotic prophylaxis and noninferior compared to fluoroquinolones.
Cefpodoxime might be a sufficient choice as an easily applicable oral antibiotic prophylaxis for transrectal prostate biopsy. The safety profile of cefpodoxime is comparable to the safety profile of fluoroquinolones.
Cefpodoxime, a relatively new third-generation oral cephalosporin with an adequate safety profile, might be a sufficient choice as oral antibiotic prophylaxis for transrectal prostate biopsy.</description><identifier>ISSN: 2405-4569</identifier><identifier>EISSN: 2405-4569</identifier><identifier>DOI: 10.1016/j.euf.2020.11.006</identifier><identifier>PMID: 33358884</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Antibiotic Prophylaxis - methods ; Cefpodoxime ; Ceftizoxime - analogs & derivatives ; Epididymitis ; Fluoroquinolones - therapeutic use ; Fusion biopsy ; Hematuria ; Humans ; Image-Guided Biopsy - methods ; Male ; Prostate - pathology ; Prostate cancer ; Prostatitis ; Retrospective Studies ; Systematic biopsy ; Ultrasonography, Interventional - methods ; Urinary tract infection</subject><ispartof>European urology focus, 2021-09, Vol.7 (5), p.980-986</ispartof><rights>2020 European Association of Urology</rights><rights>Copyright © 2020 European Association of Urology. Published by Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c353t-bf7e64f0d01cce9ccf6f8e3c11a7259ab5dcb9e2b6520594b1027850f81199733</citedby><cites>FETCH-LOGICAL-c353t-bf7e64f0d01cce9ccf6f8e3c11a7259ab5dcb9e2b6520594b1027850f81199733</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33358884$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wenzel, Mike</creatorcontrib><creatorcontrib>Welte, Maria N.</creatorcontrib><creatorcontrib>Theissen, Lena H.</creatorcontrib><creatorcontrib>Wittler, Clarissa</creatorcontrib><creatorcontrib>Hoeh, Benedikt</creatorcontrib><creatorcontrib>Humke, Clara</creatorcontrib><creatorcontrib>Preisser, Felix</creatorcontrib><creatorcontrib>Würnschimmel, Christoph</creatorcontrib><creatorcontrib>Tilki, Derya</creatorcontrib><creatorcontrib>Graefen, Markus</creatorcontrib><creatorcontrib>Roos, Frederik C.</creatorcontrib><creatorcontrib>Becker, Andreas</creatorcontrib><creatorcontrib>Karakiewicz, Pierre I.</creatorcontrib><creatorcontrib>Chun, Felix K.H.</creatorcontrib><creatorcontrib>Kluth, Luis A.</creatorcontrib><creatorcontrib>Mandel, Philipp</creatorcontrib><title>Comparison of Complication Rates with Antibiotic Prophylaxis with Cefpodoxime Versus Fluoroquinolones After Transrectal Prostate Biopsy</title><title>European urology focus</title><addtitle>Eur Urol Focus</addtitle><description>After recommended restriction of the use of fluoroquinolones, the optimal antibiotic prophylaxis for transrectal prostate biopsy is still under debate.
To test the effectiveness of cefpodoxime as oral antibiotic prophylaxis for transrectal prostate biopsies and the complication rates relative to fluoroquinolones.
Antibiotic prophylaxis for transrectal prostate biopsies at the Department of Urology at University Hospital Frankfurt was fluoroquinolones for 342 consecutive patients in January 2018 and December 2019 and cefpodoxime for 100 patients from January 2020 to July 2020. Data were prospectively evaluated and retrospectively analyzed. Patients were followed up according to clinical routine at 6 wk after biopsy at the earliest. Patients without follow-up (n = 98) and those receiving antibiotic prophylaxis other than cefpodoxime or fluoroquinolones (n = 15) were excluded.
Use of cefpodoxime or fluoroquinolones as antibiotic prophylaxis for transrectal prostate biopsies.
Logistic regression models were used to predict biopsy-related complications according to antibiotic prophylaxis.
Of 442 patients, 100 (22.6%) received cefpodoxime as antibiotic prophylaxis. Patient baseline and biopsy characteristics were comparable between the cefpodoxime and fluoroquinolone groups. Moreover, there were no differences in the number of prior prostate biopsies or the proportions of systematic vs. fusion biopsies (p > 0.05). There were no differences between the groups in infectious complications such as epididymitis and prostatitis after biopsy. Infectious complication rates were very low, at 2.0% in the cefpodoxime and0.9%fluoroquinolone group. Moreover, there were no differences between the groups in patient-reported complications, such as gross hematuria occurring at more than 5 d after biopsy, hematospermia, or rectal bleeding. In multivariable analyses, after adjustment for patient and prostate biopsy characteristics, cefpodoxime was not associated with higher complication rates than fluoroquinolones (p > 0.05).
Complications after transrectal prostate biopsies are rare and cefpodoxime might be a sufficient choice as oral antibiotic prophylaxis and noninferior compared to fluoroquinolones.
Cefpodoxime might be a sufficient choice as an easily applicable oral antibiotic prophylaxis for transrectal prostate biopsy. The safety profile of cefpodoxime is comparable to the safety profile of fluoroquinolones.
Cefpodoxime, a relatively new third-generation oral cephalosporin with an adequate safety profile, might be a sufficient choice as oral antibiotic prophylaxis for transrectal prostate biopsy.</description><subject>Antibiotic Prophylaxis - methods</subject><subject>Cefpodoxime</subject><subject>Ceftizoxime - analogs & derivatives</subject><subject>Epididymitis</subject><subject>Fluoroquinolones - therapeutic use</subject><subject>Fusion biopsy</subject><subject>Hematuria</subject><subject>Humans</subject><subject>Image-Guided Biopsy - methods</subject><subject>Male</subject><subject>Prostate - pathology</subject><subject>Prostate cancer</subject><subject>Prostatitis</subject><subject>Retrospective Studies</subject><subject>Systematic biopsy</subject><subject>Ultrasonography, Interventional - methods</subject><subject>Urinary tract infection</subject><issn>2405-4569</issn><issn>2405-4569</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9UU1v1DAUtBCIVqU_gAvykcsuz3GcD3FaVhSQKoFQ4Wo5zrP6VkkcbKd0fwF_G0e7IE6c7JHnzRvPMPZSwFaAqN4ctri4bQFFxmILUD1hl0UJalOqqn36z_2CXcd4AAChylo28jm7kFKqpmnKS_Zr78fZBIp-4t7xFQ1kTaKMv5qEkf-kdM93U6KOfCLLvwQ_3x8H80jntz262ff-kUbk3zHEJfKbYfHB_1ho8oOfssjOJQz8LpgpBrTJDKtMTHkBf0d-jscX7JkzQ8Tr83nFvt28v9t_3Nx-_vBpv7vdWKlk2nSuxqp00IOwFltrXeUalFYIUxeqNZ3qbddi0VWqANWWnYCibhS4Roi2raW8Yq9PuvPqD2PSI0WLw2Am9EvURY6oFKoGyFRxotpsNdt2eg40mnDUAvRagT7oXIFeK9BC6FxBnnl1ll-6Efu_E38Cz4S3JwLmTz4QBh0t4WSxpzUY3Xv6j_xvY2yZ8Q</recordid><startdate>202109</startdate><enddate>202109</enddate><creator>Wenzel, Mike</creator><creator>Welte, Maria N.</creator><creator>Theissen, Lena H.</creator><creator>Wittler, Clarissa</creator><creator>Hoeh, Benedikt</creator><creator>Humke, Clara</creator><creator>Preisser, Felix</creator><creator>Würnschimmel, Christoph</creator><creator>Tilki, Derya</creator><creator>Graefen, Markus</creator><creator>Roos, Frederik C.</creator><creator>Becker, Andreas</creator><creator>Karakiewicz, Pierre I.</creator><creator>Chun, Felix K.H.</creator><creator>Kluth, Luis A.</creator><creator>Mandel, Philipp</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202109</creationdate><title>Comparison of Complication Rates with Antibiotic Prophylaxis with Cefpodoxime Versus Fluoroquinolones After Transrectal Prostate Biopsy</title><author>Wenzel, Mike ; 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To test the effectiveness of cefpodoxime as oral antibiotic prophylaxis for transrectal prostate biopsies and the complication rates relative to fluoroquinolones.
Antibiotic prophylaxis for transrectal prostate biopsies at the Department of Urology at University Hospital Frankfurt was fluoroquinolones for 342 consecutive patients in January 2018 and December 2019 and cefpodoxime for 100 patients from January 2020 to July 2020. Data were prospectively evaluated and retrospectively analyzed. Patients were followed up according to clinical routine at 6 wk after biopsy at the earliest. Patients without follow-up (n = 98) and those receiving antibiotic prophylaxis other than cefpodoxime or fluoroquinolones (n = 15) were excluded.
Use of cefpodoxime or fluoroquinolones as antibiotic prophylaxis for transrectal prostate biopsies.
Logistic regression models were used to predict biopsy-related complications according to antibiotic prophylaxis.
Of 442 patients, 100 (22.6%) received cefpodoxime as antibiotic prophylaxis. Patient baseline and biopsy characteristics were comparable between the cefpodoxime and fluoroquinolone groups. Moreover, there were no differences in the number of prior prostate biopsies or the proportions of systematic vs. fusion biopsies (p > 0.05). There were no differences between the groups in infectious complications such as epididymitis and prostatitis after biopsy. Infectious complication rates were very low, at 2.0% in the cefpodoxime and0.9%fluoroquinolone group. Moreover, there were no differences between the groups in patient-reported complications, such as gross hematuria occurring at more than 5 d after biopsy, hematospermia, or rectal bleeding. In multivariable analyses, after adjustment for patient and prostate biopsy characteristics, cefpodoxime was not associated with higher complication rates than fluoroquinolones (p > 0.05).
Complications after transrectal prostate biopsies are rare and cefpodoxime might be a sufficient choice as oral antibiotic prophylaxis and noninferior compared to fluoroquinolones.
Cefpodoxime might be a sufficient choice as an easily applicable oral antibiotic prophylaxis for transrectal prostate biopsy. The safety profile of cefpodoxime is comparable to the safety profile of fluoroquinolones.
Cefpodoxime, a relatively new third-generation oral cephalosporin with an adequate safety profile, might be a sufficient choice as oral antibiotic prophylaxis for transrectal prostate biopsy.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>33358884</pmid><doi>10.1016/j.euf.2020.11.006</doi><tpages>7</tpages></addata></record> |
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| subjects | Antibiotic Prophylaxis - methods Cefpodoxime Ceftizoxime - analogs & derivatives Epididymitis Fluoroquinolones - therapeutic use Fusion biopsy Hematuria Humans Image-Guided Biopsy - methods Male Prostate - pathology Prostate cancer Prostatitis Retrospective Studies Systematic biopsy Ultrasonography, Interventional - methods Urinary tract infection |
| title | Comparison of Complication Rates with Antibiotic Prophylaxis with Cefpodoxime Versus Fluoroquinolones After Transrectal Prostate Biopsy |
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