Pd41-03 antibiotic-free transperineal prostate biopsy: urology’s contribution to responsible antimicrobial stewardship

You have accessJournal of UrologyCME1 May 2022PD41-03 ANTIBIOTIC-FREE TRANSPERINEAL PROSTATE BIOPSY: UROLOGY’S CONTRIBUTION TO RESPONSIBLE ANTIMICROBIAL STEWARDSHIP Kevin B. Ginsburg, Johnathan Drevik, Jared P. Schober, Alberto A. Castro Bigalli, Jeffrey L. Ellis, Avery Braun, Kaynaat Syed, John Danella, Serge Ginzburg, Laurence Belkoff, Adam C. Reese, Jeffrey Tomaszewski, Edouard Trabulsi, Eric A. Singer, Bruce Jacobs, Jay D. Raman, Thomas Guzzo, Robert G. Uzzo, Marc C. Smaldone, and Andres F. Correa Kevin B. GinsburgKevin B. Ginsburg More articles by this author , Johnathan DrevikJohnathan Drevik More articles by this author , Jared P. SchoberJared P. Schober More articles by this author , Alberto A. Castro BigalliAlberto A. Castro Bigalli More articles by this author , Jeffrey L. EllisJeffrey L. Ellis More articles by this author , Avery BraunAvery Braun More articles by this author , Kaynaat SyedKaynaat Syed More articles by this author , John DanellaJohn Danella More articles by this author , Serge GinzburgSerge Ginzburg More articles by this author , Laurence BelkoffLaurence Belkoff More articles by this author , Adam C. ReeseAdam C. Reese More articles by this author , Jeffrey TomaszewskiJeffrey Tomaszewski More articles by this author , Edouard TrabulsiEdouard Trabulsi More articles by this author , Eric A. SingerEric A. Singer More articles by this author , Bruce JacobsBruce Jacobs More articles by this author , Jay D. RamanJay D. Raman More articles by this author , Thomas GuzzoThomas Guzzo More articles by this author , Robert G. UzzoRobert G. Uzzo More articles by this author , Marc C. SmaldoneMarc C. Smaldone More articles by this author , and Andres F. CorreaAndres F. Correa More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002602.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: There is an emerging epidemic of multi-drug resistant organisms resulting from poor antibiotic stewardship. Transperineal (TP) prostate biopsy has a significant lower incidence of infectious related complications compared with transrectal prostate biopsy. Despite the improved infectious profile with TP biopsy, the safety of omission of pre-procedure antibiotics for men undergoing TP biopsy has not been well established. We aimed to investigate if the omission of antibiotics was associated with increased infectious related complications in men undergoing TP biopsy. METHODS: We reviewed the Pennsylvania Urologic Regional Collaborative (PURC) registry for men undergoing TP biopsy. Men were classified as those receiving any prophylactic antibiotic vs. those that did not. All patients received a local skin antiseptic preparation. Infectious outcomes of interest included post-biopsy fever, sepsis, or UTI within 30 days of the biopsy. Additional outcomes of interest include emergency room visit or readmission within 30 days of the biopsy. Proportions were compared with the Fisher’s exact test and continuous measures were compared with the Wilcoxon rank sum test. RESULTS: We identified 405 men at 7 institutions in PURC that underwent a TP biopsy from May 2015 to June 2021, of which 282 men (70%) did not receive antibiotic prophylaxis and 123 (30%) received antibiotic prophylaxis. There were a similar number of biopsy cores sampled between men that did not receive and received antibiotic prophylaxis (12 cores vs. 13 cores, p=0.641) and a similar distribution of age with most men in the age category of 60-69 years old (48% vs. 64%, p=0.166). There were no infectious complications, including post-biopsy fever, sepsis, or UTI, for men undergoing TP biopsy without (0%) or with antibiotic prophylaxis (0%). Additionally, there were no significant difference in post-biopsy ER visits among men without antibiotic prophylaxis compared with men receiving prophylaxis (0.71% vs. 0.81, p=0.664). Finally, there were no hospitalizations among the 405 men undergoing TP biopsy without or with antibiotic prophylaxis. CONCLUSIONS: Infectious complications after TP biopsy are rare. The omission of antibiotics did not increase the incidence of UTI, fever, or sepsis. These results suggest urologists may omit prophylactic antibiotics in appropriately selected patients in efforts to improve antimicrobial stewardship. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e690 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kevin B. Ginsburg More articles by this author Johnathan Drevik More articles by this author Jared P. Schober More articles by this author Alberto A. Castro Bigalli More articles by this author Jeffrey L. Ellis More articles by this author Avery Braun More articles by this author Kaynaat Syed More articles by this author John Danella More articles by this author Serge Ginzburg More articles by this author Laurence Belkoff More articles by this author Adam C. Reese More articles by this author Jeffrey Tomaszewski More articles by this author Edouard Trabulsi More articles by this author Eric A. Singer More articles by this author Bruce Jacobs More articles by this author Jay D. Raman More articles by this author Thomas Guzzo More articles by this author Robert G. Uzzo More articles by this author Marc C. Smaldone More articles by this author Andres F. Correa More articles by this author Expand All Advertisement PDF DownloadLoading ...