Antibiotic prophylaxis for transrectal prostate biopsy: a comparison of one-day and five-day regimen

• Published in: The Nigerian postgraduate medical journal 2014-09, Vol.21 (3), p.213-217
• Main Authors: Agbugui, J O, Obarisiagbon, E O, Osaigbovo, E O, Osime, C O, Akumabor, P N
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents - administration & dosage; Antibiotic Prophylaxis; Biopsy, Needle - adverse effects; Ciprofloxacin - administration & dosage; Drug Administration Schedule; Drug Therapy, Combination; Humans; Male; Metronidazole - administration & dosage; Middle Aged; Nigeria; Prospective Studies; Prostate - pathology; Prostatic Neoplasms - pathology; Rectum - surgery; transrectal prostate biopsy; Treatment Outcome; Urine - microbiology
• ISSN: 1117-1936; 2468-6875
• DOI: 10.4103/1117-1936.163514

To determine the difference in outcome between a 1- day and 5- day antibiotic regimen in the prevention of infective complications following transrectal prostate biopsy. This prospective comparative study was done in the urology unit of University of Benin Teaching Hospital over a period of 14 months. Eighty seven patients were randomly assigned to 2 groups prior to the procedure. The patients in group I (N=42) received oral ciprofloxacin (500mg, 12 hourly) and oral metronidazole (400mg, 8 hourly) for 1 day while those in group II (N=45) received same antibiotic combination for 5 days. Urine samples for culture were taken an hour before the procedure and then 5 days after in all patients. Temperature monitoring with an easy-to-use thermometer was done thrice daily by the patients. Post biopsy fever and positive urine cultures were indicative of infection. The mean age of the patients was 68.5 ± 8.1 years. Infective complications occurred in 8(19%) in group I and 7(15.6%) in group II. Fever was noted in 5 patients in group I and 4 patients in group II (p=0.73) while positive urine culture was noted in 4 patients in each group (p=1.00). Complications were minor and transient except in a case of septicaemia in group II that required hospitalisation. Escherischia coli was the most common organism isolated from positive urine cultures. A 1-day antibiotic regimen of oral ciprofloxacin and metronidazole is as effective as a 5-day regimenin the prevention of infective complications following transrectalprostate biopsy.