Korean J Urol.  2014 Sep;55(9):593-598. 10.4111/kju.2014.55.9.593.

The Real Practice of Antibiotic Prophylaxis for Prostate Biopsy in Korea Where the Prevalence of Quinolone-Resistant Escherichia coli Is High

• Kim DH
• Bae SR
• Choi WS
• Park HK
• Paick SH
• Kim HG
• Loh YS

• KMID: 2069777
• DOI: http://doi.org/10.4111/kju.2014.55.9.593

Abstract

PURPOSE
Transrectal ultrasonography-guided prostate biopsy (TRUS-Bx) is an essential procedure for diagnosing prostate cancer. The American Urological Association (AUA) Guideline recommends fluoroquinolone alone for 1 day during TRUS-Bx. However, this recommendation may not be appropriate in regions where the prevalence of quinolone-resistant Escherichia coli is high. We investigated the real practice of antibiotic prophylaxis for TRUS-Bx in Korea.
MATERIALS AND METHODS
A total of 77 hospitals performing TRUS-Bx were identified and an e-mail was sent to the Urology Department of those hospitals. The questions in the e-mail included the choice of antibiotics before and after the procedure and the duration of antibiotic therapy after TRUS-Bx.
RESULTS
A total of 54 hospitals (70.0%) responded to the e-mail. Before TRUS-Bx, all hospitals administered intravenous antibiotic prophylaxis. The percentage of hospitals that used quinolone, cephalosporin, and aminoglycoside alone was 48.1%, 20.4%, and 9.3%, respectively. The percentage of hospitals that used two or more antibiotics was 22.2%. After biopsy, all 54 hospitals prescribed oral antibiotics. The percentage of hospitals that prescribed quinolone alone, cephalosporin alone, or a combination of two or more antibiotics was 77.8%, 20.4%, and 1.8%, respectively. The duration of antibiotic use was more than 3 days in most hospitals (79.6%). Only four hospitals (7.4%) followed the AUA recommendation of a 1-day regimen.
CONCLUSIONS
The AUA recommendation was not followed by most hospitals in Korea. This clinical behavior might reflect the high quinolone resistance rate in Korea, and further studies on the most efficient prophylactic antibiotics after TRUS-Bx in Korea are warranted.

Keyword

Antibiotic prophylaxis; Biopsy; Guideline

MeSH Terms

Aminoglycosides/*administration & dosage
Anti-Bacterial Agents/*administration & dosage
Antibiotic Prophylaxis/*methods
Biopsy/adverse effects
Cephalosporins/*administration & dosage
Cross-Sectional Studies
Drug Resistance, Bacterial
Escherichia coli Infections/*prevention & control
Humans
Male
Prostate/pathology
Prostatic Neoplasms/pathology
Quinolones/*administration & dosage
Republic of Korea
Aminoglycosides
Anti-Bacterial Agents
Cephalosporins
Quinolones

Figure

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  FIG. 1 The proportion of departments performing prostate biopsy (A), and the proportion of clinical settings performing prostate biopsy (B).

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  FIG. 2 Frequency of rectal preparation type (A) and disinfective method (B) used in hospitals performing biopsy.

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