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Single Dose Levofloxacin Prophylaxis for Prostate Biopsy in Patients at Low Risk

2002; Lippincott Williams & Wilkins; Volume: 168; Issue: 3 Linguagem: Inglês

10.1016/s0022-5347(05)64565-x

1527-3792

Brian C. Griffith, Allen F. Morey, Mustafa M. Ali-Khan, Edith Canby‐Hagino, John P. Foley, Thomas A. Rozanski,

Prostate Cancer Treatment and Research

No AccessJournal of UrologyCLINICAL UROLOGY: ORIGINAL ARTICLES1 Sep 2002Single Dose Levofloxacin Prophylaxis for Prostate Biopsy in Patients at Low Risk Brian C. Griffith, Allen F. Morey, Mustafa M. Ali-Khan, Edith Canby-Hagino, John P. Foley, and Thomas A. Rozanski Brian C. GriffithBrian C. Griffith , Allen F. MoreyAllen F. Morey , Mustafa M. Ali-KhanMustafa M. Ali-Khan , Edith Canby-HaginoEdith Canby-Hagino , John P. FoleyJohn P. Foley , and Thomas A. RozanskiThomas A. Rozanski View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)64565-XAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We determine if a single 500 mg. oral tablet of levofloxacin represents adequate prophylaxis for patients at low risk who undergo transrectal prostate biopsy. Materials and Methods: From April 2000 to May 2001 we prospectively evaluated 400 consecutive men who underwent transrectal needle biopsy of the prostate after a single 500 mg. oral dose of levofloxacin. Under an institutional review board approved protocol the drug was issued under a standing order by a clinic nurse 30 to 60 minutes before the procedure. Patients were issued 2 additional daily doses of levofloxacin if they were deemed at increased risk for infectious complications, that is if they had a large prostate more than 75 cc, diabetes mellitus, recent steroid use, severe voiding dysfunction or immune compromise. No patient received a cleansing enema before the procedure. Complications, the number of biopsy cores, prostate size and cancer detection rates were assessed. Results: Only 1 of the 377 patients at low risk in whom biopsy was completed experienced a symptomatic urinary tract infection (0.27%). None of the 23 men at high risk who received additional doses of levofloxacin experienced a complication. Thus, the overall infection rate was 1 of 400 cases (0.25%) in this series. A mean of 7 biopsy cores (range 2 to 16) was obtained per patient and mean prostate volume was 49.75 cc (range 12 to 150). Prostate cancer was present in 93 patients (23%). Conclusions: A single 500 mg. dose of levofloxacin before transrectal needle biopsy of the prostate is effective and safe in patients at low risk. The administration of prophylaxis by a clinic nurse under a standing order optimizes patient compliance and physician efficiency. In patients at higher risk for infection additional antibiotic administration appears to provide adequate prophylaxis. References 1 : Transrectal ultrasound guided biopsy of the prostate. Do enemas decrease clinically significant complications?. J Urol2001; 166: 82. Link, Google Scholar 2 : Bacteremia bacteruria after transrectal ultrasound guided prostate biopsy. 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