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KMID : 0358320150560060466
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Korean Journal of Urology
2015 Volume.56 No. 6 p.466 ~ p.472
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Antibiotic prophylaxis with intravenous ceftriaxone and fluoroquinolone reduces infectious complications after transrectal ultrasound-guided prostatic biopsy
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Lee Chun-Woo
You Dal-San
Jeong In-Gab
Hong Jun-Hyuk
Choo Myung-Soo
Ahn Han-Jong
Ahn Tai-Young
Kim Choung-Soo
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Abstract
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Purpose: To assess the rates of infectious complications before and after the change of prophylactic antibiotic regimens in prostate needle biopsy.
Materials and Methods: The records of 5,577 patients who underwent prostate needle biopsy at Asan Medical Center between August 2005 and July 2012 were retrospectively reviewed. Group 1 (n=1,743) included patients treated between 2005 and 2009 with fluoroquinolone for 3 days, group 2 (n=2,723) included those treated between 2009 and 2012 with ceftriaxone once before the biopsy and fluoroquinolone before biopsy and continue therapy for 3 days, and group 3 (n=1,111) received the same treatment for more than 7 days after the biopsy. Univariable and multivariable logistic regression models addressed risk factors associated with infectious complication after prostate needle biopsy.
Results: Infectious complication after prostate needle biopsy developed in 18 (group 1), seven (group 2), and two patients (group 3) (p=0.001). In group 1, seven patients with infectious complication had positive blood cultures and harbored fluoroquinolone-resistant Escherichia coli, four had ceftriaxone susceptible isolates, and three had extended spectrum beta-lactamase-positive E. coli. Two patients in group 1 required intensive care because of septic shock. In multivariable analysis, the patients with combination of fluoroquinolone and ceftriaxone had significantly lower infectious complication rate than the fluoroquinolon alone (p=0.003).
Conclusions: Antibiotic prophylaxis with ceftriaxone and fluoroquinolone before prostate needle biopsy decreased the risk of potentially serious infectious complications.
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KEYWORD
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Antibiotic prophylaxis , Biopsy , Ceftriaxone , Infection , Prostate
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