EDITORIAL COMMENT

Increasing number of patients having trans-rectal ultrasound biopsy (TRUS-Bx) related serious infections. The main reason behind these infections may be the fluoroquinolone- resistant (FQR) bacteria. Incidence of FQR bacteria in rectal culture in Western and developing countries were 12% and 40%, respectively. The present study is first multi-centric prospective trial with a large cohort. Thirty centers were participated in the study. Group 1 (n=4087) patients were used rectal culture targeted antibiotics and/or fluoroquinolone + additional antibiotics. Group 2 (n=5028) patients were used standard antibiotics prophylaxis. Two groups were compared for infection related hospitalization (IRH) within 30 days after TRUS-Bx. The proportion of patients with IRH after TRUS-Bx decreased by 53% in group 1 (0.56% group 1 vs 1.19% group 2, p=0.002). Group 1 was subdivided into targeted and augmented antibiotic prophylaxis groups. No statistically significant difference was found between targeted (0.47%) and augmented (0.57%) groups for IRH. Though in this study 53% less hospitalization benefit was clearly shown for group 1. No advantage was confirmed in between targeted and augment prophylaxes for group 1. Emerging FQR should be kept in mind and prophylaxis alternatives should be considered.

REFERENCES

1, Urology, 85 (2015) 15-22. doi:10.1016/j.urology.2014.07.078