Clinical importance of the antibiotic regimen in transrectal ultrasound-guided biopsy: Quinolone versus cephalosporin

Jung Keun Lee, Sang Chul Lee, Sung Kyu Hong, Seok-Soo Byun, Sang Eun Lee

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Quinolone is recommended as an antimicrobial prophylaxis to prevent infectious complication after transrectal ultrasound-guided biopsy, but the increased appearance of quinolone-resistant organism has raised concerns about the efficacy of quinolone. The current study was performed to evaluate various clinical factors including antimicrobial regimens associated with infectious complication after transrectal ultrasound-guided prostate biopsy. Methods: The medical records of 5215 patients who underwent a multicore transrectal ultrasound-guided prostate biopsy between May 2003 and January 2013 at our institution were reviewed. We analyzed clinical variables including prostate-specific antigen, International Prostate Symptom Score, antimicrobial regimen, prostate size, and number of biopsy cores. Univariate and multivariate logistic regression analyses of infection-related hospitalization after prostate biopsy were performed. Results: The mean age and median prostate-specific antigen of the entire cohort were 66 years and 6.4 ng/ml, respectively. Twenty-eight (0.54 %) patients developed an infectious complication after prostate biopsy that required hospitalization. Patients who received prophylactic quinolone showed a higher infectious hospitalization rate than patients who received prophylactic third-generation cephalosporin (1.5 vs. 0.3 %; p < 0.001). Multivariate logistic regression analysis demonstrated that the International Prostate Symptom Score (odds ratio = 3.18, 95 % confidence interval 1.24-8.13, p = 0.016) and the use of third-generation cephalosporin (odds ratio = 0.21, 95 % confidence interval 0.10-0.44, p < 0.001) were independent predictors of infection-related hospitalization after prostate biopsy. Conclusion: With the emergence of quinolone-resistant microorganisms, third-generation cephalosporin may effectively reduce the risk of infectious complications after transrectal ultrasound-guided prostate biopsy. Severe lower urinary tract symptoms may also be an independent risk factor for infection-related hospitalization after transrectal ultrasound-guided prostate biopsy. Keywords: Antibiotics, Biopsy, Infection, Prostate, Transrectal ultrasound Abbreviations: BMI, Body mass index; CI, Confidence interval; IPSS, International Prostate Symptom Score; OR, Odds ratios; PSA, Prostate specific antigen; TRUS-PBx, Transrectal ultrasound-guided prostate biopsy.

Original languageEnglish
Article number51
JournalBMC Urology
Volume16
Issue number1
DOIs
StatePublished - 1 Jan 2016

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Quinolones
Cephalosporins
Prostate
Anti-Bacterial Agents
Biopsy
Hospitalization
Prostate-Specific Antigen
Odds Ratio
Confidence Intervals
Infection
Logistic Models
Regression Analysis
Lower Urinary Tract Symptoms
Medical Records
Body Mass Index

Cite this

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title = "Clinical importance of the antibiotic regimen in transrectal ultrasound-guided biopsy: Quinolone versus cephalosporin",
abstract = "Background: Quinolone is recommended as an antimicrobial prophylaxis to prevent infectious complication after transrectal ultrasound-guided biopsy, but the increased appearance of quinolone-resistant organism has raised concerns about the efficacy of quinolone. The current study was performed to evaluate various clinical factors including antimicrobial regimens associated with infectious complication after transrectal ultrasound-guided prostate biopsy. Methods: The medical records of 5215 patients who underwent a multicore transrectal ultrasound-guided prostate biopsy between May 2003 and January 2013 at our institution were reviewed. We analyzed clinical variables including prostate-specific antigen, International Prostate Symptom Score, antimicrobial regimen, prostate size, and number of biopsy cores. Univariate and multivariate logistic regression analyses of infection-related hospitalization after prostate biopsy were performed. Results: The mean age and median prostate-specific antigen of the entire cohort were 66 years and 6.4 ng/ml, respectively. Twenty-eight (0.54 {\%}) patients developed an infectious complication after prostate biopsy that required hospitalization. Patients who received prophylactic quinolone showed a higher infectious hospitalization rate than patients who received prophylactic third-generation cephalosporin (1.5 vs. 0.3 {\%}; p < 0.001). Multivariate logistic regression analysis demonstrated that the International Prostate Symptom Score (odds ratio = 3.18, 95 {\%} confidence interval 1.24-8.13, p = 0.016) and the use of third-generation cephalosporin (odds ratio = 0.21, 95 {\%} confidence interval 0.10-0.44, p < 0.001) were independent predictors of infection-related hospitalization after prostate biopsy. Conclusion: With the emergence of quinolone-resistant microorganisms, third-generation cephalosporin may effectively reduce the risk of infectious complications after transrectal ultrasound-guided prostate biopsy. Severe lower urinary tract symptoms may also be an independent risk factor for infection-related hospitalization after transrectal ultrasound-guided prostate biopsy. Keywords: Antibiotics, Biopsy, Infection, Prostate, Transrectal ultrasound Abbreviations: BMI, Body mass index; CI, Confidence interval; IPSS, International Prostate Symptom Score; OR, Odds ratios; PSA, Prostate specific antigen; TRUS-PBx, Transrectal ultrasound-guided prostate biopsy.",
author = "Lee, {Jung Keun} and Lee, {Sang Chul} and Hong, {Sung Kyu} and Seok-Soo Byun and Lee, {Sang Eun}",
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Clinical importance of the antibiotic regimen in transrectal ultrasound-guided biopsy : Quinolone versus cephalosporin. / Lee, Jung Keun; Lee, Sang Chul; Hong, Sung Kyu; Byun, Seok-Soo; Lee, Sang Eun.

In: BMC Urology, Vol. 16, No. 1, 51, 01.01.2016.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Clinical importance of the antibiotic regimen in transrectal ultrasound-guided biopsy

T2 - Quinolone versus cephalosporin

AU - Lee, Jung Keun

AU - Lee, Sang Chul

AU - Hong, Sung Kyu

AU - Byun, Seok-Soo

AU - Lee, Sang Eun

PY - 2016/1/1

Y1 - 2016/1/1

N2 - Background: Quinolone is recommended as an antimicrobial prophylaxis to prevent infectious complication after transrectal ultrasound-guided biopsy, but the increased appearance of quinolone-resistant organism has raised concerns about the efficacy of quinolone. The current study was performed to evaluate various clinical factors including antimicrobial regimens associated with infectious complication after transrectal ultrasound-guided prostate biopsy. Methods: The medical records of 5215 patients who underwent a multicore transrectal ultrasound-guided prostate biopsy between May 2003 and January 2013 at our institution were reviewed. We analyzed clinical variables including prostate-specific antigen, International Prostate Symptom Score, antimicrobial regimen, prostate size, and number of biopsy cores. Univariate and multivariate logistic regression analyses of infection-related hospitalization after prostate biopsy were performed. Results: The mean age and median prostate-specific antigen of the entire cohort were 66 years and 6.4 ng/ml, respectively. Twenty-eight (0.54 %) patients developed an infectious complication after prostate biopsy that required hospitalization. Patients who received prophylactic quinolone showed a higher infectious hospitalization rate than patients who received prophylactic third-generation cephalosporin (1.5 vs. 0.3 %; p < 0.001). Multivariate logistic regression analysis demonstrated that the International Prostate Symptom Score (odds ratio = 3.18, 95 % confidence interval 1.24-8.13, p = 0.016) and the use of third-generation cephalosporin (odds ratio = 0.21, 95 % confidence interval 0.10-0.44, p < 0.001) were independent predictors of infection-related hospitalization after prostate biopsy. Conclusion: With the emergence of quinolone-resistant microorganisms, third-generation cephalosporin may effectively reduce the risk of infectious complications after transrectal ultrasound-guided prostate biopsy. Severe lower urinary tract symptoms may also be an independent risk factor for infection-related hospitalization after transrectal ultrasound-guided prostate biopsy. Keywords: Antibiotics, Biopsy, Infection, Prostate, Transrectal ultrasound Abbreviations: BMI, Body mass index; CI, Confidence interval; IPSS, International Prostate Symptom Score; OR, Odds ratios; PSA, Prostate specific antigen; TRUS-PBx, Transrectal ultrasound-guided prostate biopsy.

AB - Background: Quinolone is recommended as an antimicrobial prophylaxis to prevent infectious complication after transrectal ultrasound-guided biopsy, but the increased appearance of quinolone-resistant organism has raised concerns about the efficacy of quinolone. The current study was performed to evaluate various clinical factors including antimicrobial regimens associated with infectious complication after transrectal ultrasound-guided prostate biopsy. Methods: The medical records of 5215 patients who underwent a multicore transrectal ultrasound-guided prostate biopsy between May 2003 and January 2013 at our institution were reviewed. We analyzed clinical variables including prostate-specific antigen, International Prostate Symptom Score, antimicrobial regimen, prostate size, and number of biopsy cores. Univariate and multivariate logistic regression analyses of infection-related hospitalization after prostate biopsy were performed. Results: The mean age and median prostate-specific antigen of the entire cohort were 66 years and 6.4 ng/ml, respectively. Twenty-eight (0.54 %) patients developed an infectious complication after prostate biopsy that required hospitalization. Patients who received prophylactic quinolone showed a higher infectious hospitalization rate than patients who received prophylactic third-generation cephalosporin (1.5 vs. 0.3 %; p < 0.001). Multivariate logistic regression analysis demonstrated that the International Prostate Symptom Score (odds ratio = 3.18, 95 % confidence interval 1.24-8.13, p = 0.016) and the use of third-generation cephalosporin (odds ratio = 0.21, 95 % confidence interval 0.10-0.44, p < 0.001) were independent predictors of infection-related hospitalization after prostate biopsy. Conclusion: With the emergence of quinolone-resistant microorganisms, third-generation cephalosporin may effectively reduce the risk of infectious complications after transrectal ultrasound-guided prostate biopsy. Severe lower urinary tract symptoms may also be an independent risk factor for infection-related hospitalization after transrectal ultrasound-guided prostate biopsy. Keywords: Antibiotics, Biopsy, Infection, Prostate, Transrectal ultrasound Abbreviations: BMI, Body mass index; CI, Confidence interval; IPSS, International Prostate Symptom Score; OR, Odds ratios; PSA, Prostate specific antigen; TRUS-PBx, Transrectal ultrasound-guided prostate biopsy.

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