Investig Clin Urol.
2023 May;64(3):289-295. 10.4111/icu.20220413.
Effectiveness of fosfomycin-based antimicrobial prophylaxis for transrectal ultrasound-guided prostate biopsy: A Korean multicenter study
- Affiliations
-
- 1Department of Urology, Chonnam National University Medical School, Gwangju, Korea
- 2Department of Urology, Chung-Ang University Hospital, Chung-Ang University School of Medicine, Seoul, Korea
- 3Department of Urology, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea
- 4Department of Urology, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea
- 5Department of Urology, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
- 6Department of Urology, Konkuk University Chungju Hospital, Konkuk University School of Medicine, Chungju, Korea
- 7Department of Urology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
- KMID: 2542252
- DOI: http://doi.org/10.4111/icu.20220413
Abstract
- Purpose
Recent studies have highlighted increasing infectious complications due to fluoroquinolone (FQ)-resistant organisms in men undergoing transrectal ultrasound-guided prostate biopsy (TRUSPB). This study investigated whether fosfomycin (FM)-based antibiotic prophylaxis reduces infections after TRUSPB and identified risk factors for infective complications.
Materials and Methods
A multicenter study was conducted in the Republic of Korea from January 2018 to December 2021. Patients undergoing prostate biopsy with FQ or FM-based prophylaxis were included. The primary outcome was the post-biopsy infectious complication rate after FQ (group 1) or FM-based antibiotic prophylaxis with FM alone (group 2) or FQ and FM (group 3). Risk factors for infectious complications after TRUSPB were secondary outcomes.
Results
Patients (n=2,595) undergoing prostate biopsy were divided into three groups according to the type of prophylactic antibiotics. Group 1 (n=417) received FQ before TRUSPB. Group 2 (n=795) received FM only and group 3 (n=1,383) received FM and FQ before TRUSPB. The overall post-biopsy infectious complication rate was 1.27%. The infectious complication rates were 2.4%, 1.9%, and 0.5% in groups 1, 2, and 3, respectively (p=0.002). In multivariable analysis, predictors of post-biopsy infectious complications included an association with health care utilization (adjusted odds ratio [OR], 4.66; 95% confidence interval [CI], 1.74–12.4; p=0.002) and combination antibiotic prophylaxis (FQ and FM) (adjusted OR, 0.26; 95% CI, 0.09–0.69; p=0.007).
Conclusions
In comparison with monotherapy with FM or FQ, combination antibiotic prophylaxis (FQ and FM) showed a lower rate of infectious complications after TRUSPB. Utilization of health care was an independent risk factor for infectious complications after TRUSPB.
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