Researchers at the University of Texas Southwestern Medical Center in Dallas analyzed the effect of implementing an augmented antibiotic prophylaxis regimen in decreasing the rate of post-biopsy infections.
The standard prophylactic regimen was used until December of 2010. Fluoroquinolone-resistant organisms were found in 73% or these patients, Mehrad Adibi, MD, and colleagues reported in The Journal of Urology (2013;189:535-540). Beginning January 2011, each patient received the standard regimen plus an additional intramuscular injection of gentamicin prior to the biopsy. The post-biopsy infection rate was reduced from 3.8% to 0.6%.
Considering the potential devastating clinical consequences and the tremendous cost of admission of life-threatening sepsis, the use of gentamicin for PNBx appears not only indicated, but cost-effective (saving $15,000 per 100 patients).