Effectiveness of fosfomycin-based antimicrobial prophylaxis for transrectal ultrasound-guided prostate biopsy: A Korean multicenter studyopen access
- Authors
- Lim, D.G.; Jung, S.I.; Hwang, E.C.; Kim, T.-H.; Bae, S.; Huh, J.-S.; Lee, S.-J.; Chung, H.; Choi, H.
- Issue Date
- May-2023
- Publisher
- 대한비뇨의학회
- Keywords
- Biopsy; Fluoroquinolones; Fosfomycin; Infection; Prostate
- Citation
- Investigative and Clinical Urology, v.64, no.3, pp 289 - 295
- Pages
- 7
- Journal Title
- Investigative and Clinical Urology
- Volume
- 64
- Number
- 3
- Start Page
- 289
- End Page
- 295
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/67653
- DOI
- 10.4111/icu.20220413
- ISSN
- 2466-0493
2466-054X
- Abstract
- Purpose: Recent studies have highlighted increasing infectious complications due to fluoroquinolone (FQ)-resistant organisms in men undergoing transrectal ultrasound-guided prostate biopsy (TRUSPB). This study investigated whether fosfomycin (FM)-based antibiotic prophylaxis reduces infections after TRUSPB and identified risk factors for infective complications.
Materials and Methods: A multicenter study was conducted in the Republic of Korea from January 2018 to December 2021. Patients undergoing prostate biopsy with FQ or FM-based prophylaxis were included. The primary outcome was the post-biopsy infectious complication rate after FQ (group 1) or FM-based antibiotic prophylaxis with FM alone (group 2) or FQ and FM (group 3). Risk factors for infectious complications after TRUSPB were secondary outcomes.
Results: Patients (n=2,595) undergoing prostate biopsy were divided into three groups according to the type of prophylactic antibiotics. Group 1 (n=417) received FQ before TRUSPB. Group 2 (n=795) received FM only and group 3 (n=1,383) received FM and FQ before TRUSPB. The overall post-biopsy infectious complication rate was 1.27%. The infectious complication rates were 2.4%, 1.9%, and 0.5% in groups 1, 2, and 3, respectively (p=0.002). In multivariable analysis, predictors of post-biopsy infectious complications included an association with health care utilization (adjusted odds ratio [OR], 4.66; 95% confidence interval [CI], 1.74–12.4; p=0.002) and combination antibiotic prophylaxis (FQ and FM) (adjusted OR, 0.26; 95% CI, 0.09–0.69; p=0.007).
Conclusions: In comparison with monotherapy with FM or FQ, combination antibiotic prophylaxis (FQ and FM) showed a lower rate of infectious complications after TRUSPB. Utilization of health care was an independent risk factor for infectious complications after TRUSPB.
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