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Antibiotic prophylaxis with intravenous ceftriaxone and fluoroquinolone reduces infectious complications after transrectal ultrasound-guided prostatic biopsy

대한비뇨기과학회지 2015년 56권 6호 p.466 ~ 472
 ( Lee Chun-Woo ) - University of Ulsan College of Medicine Asan Medical Center Department of Urology

 ( You Dal-San ) - University of Ulsan College of Medicine Asan Medical Center Department of Urology
 ( Jeong In-Gab ) - University of Ulsan College of Medicine Asan Medical Center Department of Urology
 ( Hong Jun-Hyuk ) - University of Ulsan College of Medicine Asan Medical Center Department of Urology
 ( Choo Myung-Soo ) - University of Ulsan College of Medicine Asan Medical Center Department of Urology
 ( Ahn Han-Jong ) - University of Ulsan College of Medicine Asan Medical Center Department of Urology
 ( Ahn Tai-Young ) - University of Ulsan College of Medicine Asan Medical Center Department of Urology
 ( Kim Choung-Soo ) - University of Ulsan College of Medicine Asan Medical Center Department of Urology

Abstract


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.

키워드

Antibiotic prophylaxis ; Biopsy ; Ceftriaxone ; Infection ; Prostate
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