scholarly journals The use of prophylactic single-dose fosfomycin in patients who undergo transrectal ultrasound-guided prostate biopsy: A prospective, randomized, and controlled clinical study

2015 ◽  
Vol 9 (11-12) ◽  
pp. 863 ◽  
Author(s):  
Volkan Sen ◽  
Ozgu Aydogdu ◽  
Ibrahim Halil Bozkurt ◽  
Tarik Yonguc ◽  
Pinar Sen ◽  
...  
Keyword(s):  
Single Dose ◽  
Antibiotic Prophylaxis ◽  
Transrectal Ultrasound ◽  
Infectious Complications ◽  
Power Calculation ◽  
Ultrasound Guided ◽  
Febrile Uti ◽  
Fosfomycin Trometamol ◽  
Group 2 ◽  
Group 1

<p><strong>Introduction:</strong> We aimed to demonstrate the efficacy, safety, and convenient use of fosfomycin trometamol in the preoperative antibiotic prophylaxis (PAP) of transrectal ultrasound-guided biopsy of the prostate (TRUSBP) in this prospective, randomized study.</p><p><strong>Methods:</strong> Between May 2014 and May 2015, a total of 300 patients who underwent TRUSBP were examined prospectively. Patients were randomized into two groups: group 1 consisted of 150 patients who were administered a single dose of 3 g oral fosfomycin as a PAP the night before the procedure; group 2 consisted of 150 patients who were administered 500 mg oral ciprofloxacin 60 min before the procedure as a PAP. Post-procedural febrile and afebrile infectious complications and pathological characteristics of the two groups were compared prospectively.</p><p><strong>Results:</strong> The mean age of the patients was 63.5±0.6 years in group 1 and 62.9±0.6 years in group 2. A total of two patients (1.3%) in group 1 and nine patients (6.0%) in group 2 experienced afebrile urinary tract infection (UTI). Afebrile UTI rate was significantly higher in group 2 (1.3% s. 6.0%, p=0,032). Febrile UTI was detected in two patients in group 2 and one patient in group 1. Urine cultures revealed 35.7% fluoroquinolone resistance. As a limitation, although the sample size was appropriate due to the power calculation, we believe that comprehensive studies including larger patient cohorts are needed to support our findings.</p><p><strong> Conclusions:</strong> Due to its ease-of-use with only a single dose and lower rates of infectious complications (resistant and febrile UTIs), fosfomycin trometamol is a strong alternative for antibiotic prophylaxis in TRUSBP.</p>

scholarly journals Addition of Ceftriaxone and Amikacin to a Ciprofloxacin plus Metronidazole Regimen for Preventing Infectious Complications of Transrectal Ultrasound-Guided Prostate Biopsy: A Randomized Controlled Trial

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Mohammad-Hossein Izadpanahi ◽  
Kia Nouri-Mahdavi ◽  
Seyed Mahmood Majidi ◽  
Mohammad-Hatef Khorrami ◽  
Farshid Alizadeh ◽  
...  
Keyword(s):  
Prostate Biopsy ◽  
Controlled Trial ◽  
Intervention Group ◽  
Transrectal Ultrasound ◽  
Infectious Complications ◽  
Control Group ◽  
Ultrasound Guided ◽  
Prophylactic Regimen ◽  
Randomized Controlled ◽  
Group 1

Background. The objective of this study was to evaluate the efficacy of adding single doses of ceftriaxone and amikacin to a ciprofloxacin plus metronidazole regimen on the reduction of infectious complications following transrectal ultrasound-guided prostate biopsy (TRUS Bx). Materials and Methods. Four hundred and fifty patients who were candidates for TRUS Bx were divided into two groups of 225 each. The control group received ciprofloxacin 500 mg orally every 12 hours together with metronidazole 500 mg orally every 8 hours from the day prior to the procedure until the fifth postoperative day. In the second group, single doses of ceftriaxone 1 g by intravenous infusion and amikacin 5 mg/kg intramuscularly were administered 30–60 minutes before TRUS Bx in addition to the oral antimicrobials described for group 1. The incidence of infection was compared between the groups. Results. The incidence of infectious complications in the intervention group was significantly lower than that in the control group (4.6% versus 0.9%, p=0.017). Conclusion. The addition of single doses of intramuscular amikacin and intravenously infused ceftriaxone to our prophylactic regimen of ciprofloxacin plus metronidazole resulted in a statistically significant reduction of infectious complications following TRUS Bx.

scholarly journals Single Dose of Levofloxacin versus Three Dosages for Prophylaxis in Prostate Biopsy

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Edgar Linden-Castro ◽  
Marcela Pelayo-Nieto ◽  
Alejandro Alias-Melgar ◽  
Fernando Carreño-de la Rosa
Keyword(s):  
Prostate Cancer ◽  
Single Dose ◽  
Prostate Biopsy ◽  
Antimicrobial Agents ◽  
Transrectal Ultrasound ◽  
Infectious Complications ◽  
Ultrasound Guided ◽  
Prophylactic Regimen ◽  
Local Pain ◽  
Number Of Patients

Transrectal ultrasound-guided core prostate biopsy is a key event in the diagnosis of prostate cancer, transient side events such as local pain, haematuria, haematospermia, dysuria, and rectal bleeding are reported in a large number of patients. Antimicrobial agents lower the incidence of postbiopsy infectious complications. The timing and duration of the regimen and the route of administration remain controversial. We developed a standard prophylactic regimen, in which safety and efficiency were maximized, while costs and variability were minimized. Accordingly we prospectively evaluated 425 consecutive patients, who underwent outpatient transrectal ultrasound-guided prostate biopsy after a single dose versus three doses of levofloxacin.

scholarly journals Transrectal Ultrasound-Guided Prostate Biopsy, Periprostatic Local Anesthesia and Pain Tolerance

2010 ◽  
Vol 10 (1) ◽  
pp. 66-72 ◽  
Author(s):  
Mustafa Hiroš ◽  
Mirsad Selimović ◽  
Hajrudin Spahović ◽  
Sabina Sadović ◽  
Ediba Spužić-Čelić
Keyword(s):  
Local Anesthesia ◽  
Prostate Biopsy ◽  
Transrectal Ultrasound ◽  
Pain Tolerance ◽  
Ultrasound Guided ◽  
Lidocaine Group ◽  
Pain Scores ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

We have evaluated objectively pain tolerance in transrectal ultrasound-guided prostate biopsy (TRUS) using local periprostatic per rectal anesthesia as compared to the conventional method. From November 2008 to May 2009, 90 patients underwent transrectal ultrasound-guided prostate biopsy at Department of Urology, Clinical Center University Sarajevo. 90 patients who fulfilled the inclusion criteria were randomized into 3 groups of 30 patients each. Group 1 received periprostatic local anesthesia with 2% lidocaine, group 2 received Voltaren supp placed in rectum an hour before biopsy while group 3 received no local anesthesia. Pain scale responses were analyzed for each aspect of the biopsy procedure with a visual analog scale of 0-none to 10-maximal. There was no difference between the 3 groups in pain scores during digital rectal examination, intrarectal injection and probe insertion. The mean pain scores during needle insertion in group 1 receiving periprostatic nerve block and in group 2 receiving Voltaren supp were 3,10 ± 2,32 and 5,15 ± 2,01 respectively. In group 3 (no local anesthesia), mean pain scores were 6,06 ± 2,95 which was found to be significantly different (p < 0,001). However, morbidity after the biopsy was not statistically different between all 3 groups. TRUS-guided prostate biopsy is a traumatic and painful experience, but the periprostatic blockage use is clearly associated with more tolerance and patient comfort during the exam. It is an easy, safe, acceptable and reproducible technique and should be considered for all patients undergoing TRUS biopsy regardless of age or number of biopsies.

scholarly journals Does The Use Of Povidone Iodine Suppository Decrease The Infective Complications Of TRUS Guided Prostate Biopsies? A Randomized Prospective Study

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M S Abdulbaki ◽  
A Emam ◽  
M Badawy ◽  
H S Shaker
Keyword(s):  
Antibiotic Prophylaxis ◽  
Prostate Biopsy ◽  
Povidone Iodine ◽  
Rectal Swab ◽  
Transrectal Ultrasound ◽  
Infectious Complications ◽  
Control Group ◽  
Ultrasound Guided ◽  
Tract Infections

Abstract Purpose Trans rectal ultrasound guided prostate biopsy can lead to urinary tract infections in 3% to 11% and sepsis in 0.1% to 5% of patients. We investigated the prevalence of different organisms among rectal flora in our community, the virulence of the most prevalent one and the effect of combined standard antibiotic prophylaxis with the use of povidone iodine suppository prior to TRUS guided biopsy of the prostate in decreasing post biopsy infectious complications. Materials and Methods Between December 2016 and September 2017, 50 men were prospectively randomized to povidone iodine rectal cleansing (50) or no cleansing (50) before transrectal ultrasound guided prostate biopsy. Rectal swab cultures, urinalaysis, urine cultures, total leukocytic count and CRP were obtained before transrectal ultrasound guided prostate biopsy. Patients received ciprofloxacin prophylaxis and attended at 1 week follow up visit. Urinalaysis, urine cultures, total leukocytic count and CRP were obtained at follow up visit and asked about fever, UTI symptoms and examined for prostatitis and epididymo-orchitis. Results Infectious complications were observed in 5 (10%) patients, including 2 (8%) in the treatment group and 3 (12%) in the control group (p = 0.0001). No cases of sepsis were recorded. Mean increase of CRP was higher in control group (P = 0.011). 17 patients among study population had Ciprofloxacin resistant rectal organisms on rectal swab cultures (34%). Conclusion Usage of pre TRUS-Bx intrarectal povidone iodine suppository together with standard antibiotic prophylaxis with ciprofloxacin helps decrease post procedure infectious complications and proved to decrease incidence of infection among patients having ciprofloxacin resistant rectal organisms.

scholarly journals A single-dose antibiotic prophylaxis to prevent surgical site infection in clean-contaminated surgery among diabetic patients

2015 ◽  
Vol 1 (2) ◽  
pp. 8-10
Author(s):  
Kamal Koirala ◽  
Rupesh Mukhia ◽  
Suman Sharma ◽  
Sujan Manandhar ◽  
Niroj Banepali ◽  
...  
Keyword(s):  
Single Dose ◽  
Surgical Site Infection ◽  
Antibiotic Prophylaxis ◽  
Diabetic Patients ◽  
Outpatient Basis ◽  
Site Infection ◽  
Significant Difference ◽  
Group 2 ◽  
Clean Contaminated ◽  
Group 1

Introductions: Guidelines on antibiotics use in surgical patients recommends a single dose prophylaxis for clean-contaminated cases and therapeutic course for contaminated and dirty cases. Compliance to this guideline is poor among diabetic patients. The aim of this study was to test the efficacy of single dose antibiotic prophylaxis on the occurrence of postoperative surgical site infection (SSI) in clean-contaminated surgery in diabetic patients.Methods: Retrospective cross-sectional study was carried out at KIST Medical College and Teaching Hospital from September 2008 to August 2012 involving 144 diabetic patients who underwent major clean-contaminated surgery. Forty eight patients received one gram of ceftriaxone intravenously as prophylactic antibiotic within 30 minutes prior to incision (group 1) and 96 patients received three doses of ceftriaxone (group 2). One dose was given within 30 minutes prior to incision and other two doses were given postoperatively. All patients were followed up for 30 postoperative days on outpatient basis. The SSI rates were compared in two groups. Pus from the infected wound was tested for culture and sensitivity.Results: The SSI rates in group 1 and group 2 were of 5/48 (10.42%) and of 9/96 (9.37%) respectively. There was no significant difference in SSI rates between group 1 and group 2 (p=0.322).Conclusions: Single dose of Ceftriaxone shows the similar effect as three doses in clean-contaminated surgery in diabetic patients.

scholarly journals A novel approach in non-surgical management of tubal ectopic: combination of minimally invasive technique under ultrasound guidance with systemic methotrexate based on initial beta-HCG levels

2021 ◽  
Author(s):  
Mayoukh Kumar Chakraborty ◽  
Shalini Gainder ◽  
Subhas Chandra Saha ◽  
Rashmi Bagga
Keyword(s):  
Single Dose ◽  
Ectopic Pregnancy ◽  
Success Rate ◽  
Surgical Management ◽  
Dose Regimen ◽  
Ultrasound Guided ◽  
Group 3 ◽  
Group 2 ◽  
Β Hcg ◽  
Group 1

Background: Single dose methotrexate is the most preferred method of non-surgical management of unruptured tubal ectopic. A 2-dose regimen is suggested to treat tubal ectopic with higher trophoblastic cell load. Minimally invasive technique of ultrasound guided intracardiac KCL instillation along with systemic methotrexate has been in use even for live ectopic pregnancy. Objective of the study was to evaluate the success rate of single dose regimen of MTX (Methotrexate), 2-dose regimen of MTX and ultrasound guided instillation of intracardiac KCl in three different cohort of unruptured tubal ectopic pregnancy with an attempt to increase success of non-surgical management.Methods: Fifty-eight women with unruptured tubal ectopic pregnancy were assigned to treatment protocols according to the initial β-HCG levels and presence/absence of FCA (fetal cardiac activity). Group 1: presence of FCA in the tubal ectopic; Group 2: initial β-HCG ≤5000 IU/ml; Group 3:  initial β-HCG ≥5000 IU/ml without FCA. Women in group 1 were treated with ultrasound guided instillation of intracardiac KCl combined with systemic MTX. While women in group 2 were administered single dose regimen of MTX and group 3 received 2-dose regimen of MTX.Results: Overall success rate of non-surgical management was 89.3% across all groups. Success rate in Group 1 was 78.6%. Success rate was 93.1% in group 2 while 92.3% in group 3. Rupture rate was 1.7% in the present study.Conclusions: For non-surgical management categorizing and treating is an option with good result. Women with presence of cardiac activity can opt for non-surgical option with likely resolution in 78% cases.

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