Can Rectal Cultures Before Prostate Biopsy Help Guide Antibiotic Prophylaxis?

In a randomized trial, patients who received fluoroquinolone prophylaxis when prior rectal culture contained fluoroquinolone-resistant organisms had 6.2-fold excess risk for postbiopsy infection.

Transrectal prostate biopsies (TRPBs) have been associated with up to a 6% risk for infection caused by enteric bacteria introduced into the prostate and urinary tract, so prophylactic fluoroquinolone (FQ) therapy is recommended. However, the recent rise in FQ-resistant enteric flora has been associated with excess risk for FQ-resistant infections after TRPB. One strategy to overcome this is to base prophylaxis on rectal culture results prior to the procedure. Dutch investigators performed a nonblinded, randomized trial involving 1288 patients undergoing TRPB at 11 hospitals. Rectal swab cultures were obtained ≥7 days before the procedure and isolates were assayed for FQ resistance. Participants were randomly assigned to FQ prophylaxis or c…

Reviewing Author

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Can Rectal Cultures Before Prostate Biopsy Help Guide Antibiotic Prophylaxis?

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Reviewing Author