Many Serious Post-Biopsy Infections Avoidable

Clinicians need to follow AUA guidelines and address fluoroquinolone resistance.
Clinicians need to follow AUA guidelines and address fluoroquinolone resistance.

ORLANDO—About 1% of men who have undergone transrectal biopsy for prostate cancer (PCa) are treated for infection-related hospitalizations, according to a Michigan study presented at the American Urological Association (AUA) 2014 annual meeting.

“While transrectal prostate biopsy is the cornerstone of PCa diagnosis, serious post-biopsy infectious complications are reported to be increasing,” researchers led by Paul Womble, MD, of the University of Michigan, wrote in their study abstract. “A better understanding of the true prevalence and microbiology of these events is needed to guide quality improvement.”

The investigators analyzed data from the Michigan Urological Surgery Improvement Collaborative (MUSIC) registry, which included 21 practices across the state from March 2012 through June 2013. They recorded prophylactic antibiotic use, culture data, and all biopsy-related hospitalizations within 30 days of procedure. They then extrapolated their results across practices in accordance with AUA guidelines.

Within 30 days of biopsy, the hospitalization rate was 0.97%, ranging from 0% to 4.2% across all Michigan MUSIC practices. Among them, 97% of hospitalizations were for infectious complications. Most cultures identified fluoroquinolone-resistant bacteria.

AUA-concordant antibiotics were administered to 96.3% of men who underwent biopsy. Patients who received noncompliant antibiotics were significantly more likely to be hospitalized for infection (3.8% vs. 0.89%).

“Our findings suggest that many of these events could be avoided by implementing new protocols that both adhere with AUA best practice recommendations and address fluoroquinolone resistance,” the researchers concluded.

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