Monoprophylaxis With Cephalosporins for Transrectal Prostate Biopsy After the Fluoroquinolone-Era: A Multi-Institutional Comparison of Severe Infectious Complications

Frontiers in Oncology, Vol. 11 (2021)

Mots clés
Auteurs
  • Mike Wenzel
  • Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Frankfurt, Germany
  • Mike Wenzel
  • Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, QC, Canada
  • Mike Wenzel
  • GeSRU Academics Prostate Cancer Working Group, Planegg, Germany
  • Jost von Hardenberg
  • GeSRU Academics Prostate Cancer Working Group, Planegg, Germany
  • Jost von Hardenberg
  • Department of Urology and Urosurgery, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
  • Maria N. Welte
  • Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Frankfurt, Germany
  • Maria N. Welte
  • GeSRU Academics Prostate Cancer Working Group, Planegg, Germany
  • Samuel Doryumu
  • Department of Urology and Urosurgery, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
  • Benedikt Hoeh
  • Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Frankfurt, Germany
  • Clarissa Wittler
  • Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Frankfurt, Germany
  • Thomas Höfner
  • GeSRU Academics Prostate Cancer Working Group, Planegg, Germany
  • Thomas Höfner
  • Department of Urology, University Hospital Mainz, Mainz, Germany
  • Maximilian C. Kriegmair
  • Department of Urology and Urosurgery, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
  • Maurice S. Michel
  • Department of Urology and Urosurgery, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
  • Felix KH. Chun
  • Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Frankfurt, Germany
  • Jonas Herrmann
  • GeSRU Academics Prostate Cancer Working Group, Planegg, Germany
  • Jonas Herrmann
  • Department of Urology and Urosurgery, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
  • Philipp Mandel
  • Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Frankfurt, Germany
  • Niklas Westhoff
  • GeSRU Academics Prostate Cancer Working Group, Planegg, Germany
  • Niklas Westhoff
  • Department of Urology and Urosurgery, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany

Résumé

BackgroundTo compare severe infectious complication rates after transrectal prostate biopsies between cephalosporins and fluoroquinolones for antibiotic monoprophylaxis.Material and MethodsIn the multi-institutional cohort, between November 2014 and July 2020 patients received either cefotaxime (single dose intravenously), cefpodoxime (multiple doses orally) or fluoroquinolones (multiple-doses orally or single dose intravenously) for transrectal prostate biopsy prophylaxis. Data were prospectively acquired and retrospectively analyzed. Severe infectious complications were evaluated within 30 days after biopsy. Logistic regression models predicted biopsy-related infectious complications according to antibiotic prophylaxis, application type and patient- and procedure-related risk factors.ResultsOf 793 patients, 132 (16.6%) received a single dose of intravenous cefotaxime and were compared to 119 (15%) who received multiple doses of oral cefpodoxime and 542 (68.3%) who received fluoroquinolones as monoprophylaxis. The overall incidence of severe infectious complications was 1.0% (n=8). No significant differences were observed between the three compared groups (0.8% vs. 0.8% vs. 1.1%, p=0.9). The overall rate of urosepsis was 0.3% and did not significantly differ between the three compared groups as well.ConclusionMonoprophylaxis with third generation cephalosporins was efficient in preventing severe infectious complications after prostate biopsy. Single intravenous dose of cefotaxime and multiday regimen of oral cefpodoxime showed a low incidence of infectious complications <1%. No differences were observed in comparison to fluoroquinolones.

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