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- Title
Comparison of ciprofloxacin versus fosfomycin versus fosfomycin plus trimethoprim/sulfamethoxazole for preventing infections after transrectal prostate biopsy.
- Authors
Bovo, Alberto; Kwiatkowski, Maciej; Manka, Lukas; Wetterauer, Christian; Fux, Christoph Andreas; Cattaneo, Marco; Wyler, Stephen F.; Prause, Lukas
- Abstract
Background: To evaluate antibiotic prophylaxis in transrectal prostate biopsies due to the recommendation of the European Medicines Agency (EMA): We describe our single center experience switching from ciprofloxacin to fosfomycin trometamol (FMT) alone and to an augmented prophylaxis combining fosfomycin and trimethoprim/sulfamethoxazole (TMP/SMX). Methods: Between 01/2019 and 12/2020 we compared three different regimes. The primary endpoint was the clinical diagnosis of an infection within 4 weeks after biopsy. We enrolled 822 men, 398 (48%) of whom received ciprofloxacin (group-C), 136 (16.5%) received FMT (group-F) and 288 (35%) received the combination of TMP/SMX and FMT (group-BF). Results: Baseline characteristics were similar between groups. In total 37/398 (5%) postinterventional infections were detected, of which 13/398 (3%) vs 18/136 (13.2%) vs 6/288 (2.1%) were detected in group-C, group-F and group-BF respectively. The relative risk of infectious complication was 1.3 (CI 0.7–2.6) for group-C vs. group-BF and 2.8 (CI 1.4–5.7) for group-F vs. group-BF respectively. Conclusion: The replacement of ciprofloxacin by fosfomycin alone resulted in a significant increase of postinterventional infections, while the combination of FMT and TMP/SMX had a comparable infection rate to FQ without apparent adverse events. Therefore, this combined regimen of FMT and TMP/SMX is recommended.
- Subjects
EUROPEAN Medicines Agency; PROSTATE biopsy; FOSFOMYCIN; CIPROFLOXACIN; SULFAMETHOXAZOLE; TRIMETHOPRIM; RETENTION of urine
- Publication
World Journal of Urology, 2024, Vol 42, Issue 1, p1
- ISSN
0724-4983
- Publication type
Article
- DOI
10.1007/s00345-024-05048-4