Prophylactic Antibiotics In Transperineal Prostate Biopsies. Are They Really Necessary?

You have accessJournal of UrologyProstate Cancer: Detection & Screening II (MP26)1 Sep 2021MP26-03 PROPHYLACTIC ANTIBIOTICS IN TRANSPERINEAL PROSTATE BIOPSIES. ARE THEY REALLY NECESSARY? Fernando Bianco, Eusebio Luna, Alberto Lopez-Prieto, Farshad Shafizadeh, Hu Jim, Edward Gheiler, Ariel Kaufman, Juan Martinez-Salamanca, Luanda Y. Perez, Barrios Dailianys, Gloria Egui-Benatuil, and Michael Kattan Fernando BiancoFernando Bianco More articles by this author , Eusebio LunaEusebio Luna More articles by this author , Alberto Lopez-PrietoAlberto Lopez-Prieto More articles by this author , Farshad ShafizadehFarshad Shafizadeh More articles by this author , Hu JimHu Jim More articles by this author , Edward GheilerEdward Gheiler More articles by this author , Ariel KaufmanAriel Kaufman More articles by this author , Juan Martinez-SalamancaJuan Martinez-Salamanca More articles by this author , Luanda Y. PerezLuanda Y. Perez More articles by this author , Barrios DailianysBarrios Dailianys More articles by this author , Gloria Egui-BenatuilGloria Egui-Benatuil More articles by this author , and Michael KattanMichael Kattan More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002023.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Infectious complications, like urosepsis represent unfortunate harm associated to transrectal biopsies (TRBx), occurring in 1 out 25 procedures. By contrary, Transperineal Prostate Biopsies (TPBx) are not associated with infections, yet antibiotics are commonly used. We performed a prospective study evaluating adverse events after Fusion TPBx including the impact of antibiotics prior to fusion TPBx. METHODS: For this study, we evaluated Fusion TPBx conducted from 2017 to 2020. All patients received a single dose of cephalosporin or gentamicin (if penicillin allergic) in 2017 and 2018. Starting 01/2019 no antibiotics were administered to patients from the two busiest surgeons. Post biopsies follow up consisted of a results visitation and a 30-day phone call. A survey that inquired common adverse events (AE) was administered to each patient. The information from the procedure and 30-day outcomes was prospectively collected into the FocalyxApp (IOS & Android) We evaluated the impact of antibiotic administration on AE. Correlations between covariates such as: age, BMI, PSA, TPBx indication, piRADS, MR prostate volume, number of cores on AE and Cancer Detection were performed using chi-squares, Bayesan and regression statistics. RESULTS: 1,208 Fusion TPBx were performed on 1,179 patients across 4 clinics. Antibiotics were avoided in 480 (40%) of the procedures. Median Age, BMI, PSA, MR volume, cores, pain reported and Fusion TPBx time was 68.8 years, 27.8 kg/m2, 5.6 ng/ml, 51cc, 16, 3/10 and 19min, respectively. Cancer was detected in 525 (43.5%)/1,208. At 30 days, 46 patients experienced an AE, none experience any bacterial proven infection. The most common being urinary retention which correlated with MR Prostate Volume (Spearman, p=0.001) The TABLE shows the breakdown of AE by antibiotic, cancer history and piRADS groups. 914 of the procedures were conducted because elevation in PSA, DRE findings or both. 364 (40%) of these were positive for prostate cancer and correlated piRADS (p=0.001) with MRpiRADS 2 (6/47-13%), 3 (91/434-21%), 4(154/285-54%) and 5 (113/148-76%). CONCLUSIONS: Our study strongly supports antibiotic avoidance when conducting fusion TPBx challenging the current paradigms. Overall fusion TPBx are reliable and safe with a low incidence of AE. Prospective multicenter trials are required to support or negate this finding. Source of Funding: none © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e463-e463 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Fernando Bianco More articles by this author Eusebio Luna More articles by this author Alberto Lopez-Prieto More articles by this author Farshad Shafizadeh More articles by this author Hu Jim More articles by this author Edward Gheiler More articles by this author Ariel Kaufman More articles by this author Juan Martinez-Salamanca More articles by this author Luanda Y. Perez More articles by this author Barrios Dailianys More articles by this author Gloria Egui-Benatuil More articles by this author Michael Kattan More articles by this author Expand All Advertisement Loading ...