Session: MP15: Infections/Inflammation/Cystic Disease of the Genitourinary Tract: Prostate & Genitalia
MP15-16: Single Dose Antibiotics at the Time of Transperineal Prostate Biopsy Are Equivalent to Outpatient Antibiotic Prophylaxis in Preventing Infection
Introduction: There has been a trend towards transperineal (TP) prostate biopsy over transrectal (TR) due to a reduced rate of infection. In response, there is now an ongoing debate as to the need for prophylactic antibiotics during TP biopsy. The objective of this study was to argue for the non-inferiority of single-dose antibiotics at the time of biopsy to outpatient antibiotics in preventing infection, regardless of antibiotic class chosen. Methods: Biopsies were performed using TP technique under TR ultrasound guidance with anesthesia. All patients from 2012-present who underwent TP biopsy were identified and retrospectively chart reviewed. Infection was defined as at least one of the following: fever (=38.3 °C) or positive urine culture (>10^5 CFU) within 72 hours post-biopsy. Patients were divided into 2 groups, those who received antibiotics at the time of biopsy along with outpatient antibiotics either before/after biopsy (group 1) and those who only received intraoperative antibiotics at the time of biopsy (group 2). Antibiotic choice and duration were at the discretion of the treating physician. Pearson’s Chi Squared was run to evaluate the difference in infection rate between the 2 groups. Fisher’s exact test evaluated the relationship between type of antibiotic and infection rate. Results: A total of 767 biopsies were included in the study. Group 1 had 327 patients and group 2 had 440 patients. Infection rate post-TP biopsy was 1.97% (N=15). The infection rate for group 1 was 1.83% (N=6) and 2.05% (N=9) in group 2. No significant difference in infection rate existed between group 1 and group 2 (p=0.835). Secondary analysis was performed to evaluate infection rates based on antibiotic agent. TP biopsies with multiple antibiotics used at the same time were excluded from analysis. The type of antibiotic administered did not change infection rates within group 1 (p>0.99), group 2 (p=0.673), or between groups 1 and 2 (p>0.99). Conclusions: Based on our data, it appears that single dose antibiotics at the time of TP prostate biopsy are equivalent to outpatient antibiotic prophylaxis in preventing infection. Further, the class of antibiotic does not seem to affect infection rates. Given the overall low rate of infection, antibiotic regimens should be further evaluated for their utility. SOURCE OF Funding: N/A
