Single-dose piperacillin/tazobactam as prophylaxis in transrectal prostate biopsy

Abstract

Background

The increasing resistance to quinolones has led to the consideration of other antibiotic options for the prevention of infectious complications in prostate biopsy. We present our experience using a single dose of piperacillin/tazobactam as prophylaxis.

Methods

A retrospective study of transrectal prostate biopsies performed at our institution from 2008 to 2013 was conducted. All patients received enemas before biopsy and a single 4.5 g dose of piperacillin/tazobactam was administered i.v. a few minutes before the biopsy. Clinical and microbiological variables were analyzed to find out risk factors for complications.

Results

A total of 543 biopsies were included. Ninety-two complications (16.9%) were reported in 74 (13.6%) patients, 4.2% of which were infectious complications. In these patients, the associated risk factors were a previous history of positive urine cultures within a 3-year period before biopsy, the presence of a transurethral indwelling catheter at the time of the biopsy, hospital admission within a month before biopsy, and a preoperative positive urine culture despite antibiotic therapy selected according to the resistance pattern.

Conclusions

Physicians and patients should be aware of the risk for complications, particularly if risk factors are present. A single dose of piperacillin/tazobactam is a reasonable option for prophylaxis, especially in countries with a high prevalence of quinolone-resistant pathogens.