Prophylactic antibiotics and hospitalisations following transrectal prostate biopsy : a local retrospective cohort study

Abstract

BACKGROUND: Prostate biopsy is an important tool in prostate cancer diagnosis. However, transrectal prostate biopsy is associated with a number of complications, including infectious complications. This local cohort study aims to assess the incidence of such complications and 30-day readmission rates, and any predisposing factors for said complications including patient co-morbidities, type of prophylactic antibiotics used and biopsy approach.

METHODS: A retrospective review was carried out for men over 18 years of age who underwent transrectal prostate biopsy from January 2021 to December 2021.

RESULTS: A total of 373 patients were included. 184 (49.4%) underwent systematic biopsy, 115 (30.8%) underwent combined and 59 (15.8%) underwent targeted biopsy. The commonest antibiotic prophylaxis regime is ciprofloxacin, metronidazole and gentamicin. 30-day readmission count was 19 (5.1%). The commonest complication requiring readmission was lower UTI (n=14 (73%)), 70% of these has Escherichia coli cultured in the urine.

CONCLUSION: This study replicated the findings that infectious complications are the most common cause of readmission after transrectal biopsy and that E.coli is the most common causative organism for infectious complications post biopsy. This study does not replicate the findings from similar studies which showed that the number of cores yielded correlates with the risk of infection post biopsy, nor does it confirm that increased age, DM or a high BMI increases the risk of developing post biopsy infection.