Fluoroquinolones Up Risk of Post-Biopsy Acute Prostatitis
Isolated gram-negative bacteria were fluoroquinolone-resistant in 85.7 percent of cultures
FRIDAY, Sept. 16 (HealthDay News) -- In patients who undergo transrectal prostate biopsy, prior use of fluoroquinolones is the most significant risk factor for developing post-procedure acute prostatitis, according to a study published in the September issue of Urology.
Ashraf A. Mosharafa, M.D., from Cairo University in Egypt, and colleagues evaluated the frequency of and potential risk factors for infection-related complications after transrectal prostate biopsy, and proposed adjustments in current antimicrobial prophylaxis recommendations. Charts of 107 patients who underwent transrectal prostate biopsy between 2008 and 2010 were reviewed for infection-related complications within 30 days of the procedure. Potential risk factors (age, diabetes mellitus, chronic constipation/diverticular disease, prior use of quinolones, enema, and prostatitis on the pathology report) were evaluated. Urine and blood samples were examined for bacteriology and antibiotic susceptibility in patients with prostatitis.
The investigators identified acute prostatitis in 9.3 percent of the patients. Prior use of a fluoroquinolone antimicrobial was the most significant risk factor, with acute prostatitis developing in 17.1 percent of patients who had used fluoroquinolone versus in 4.5 percent of patients who had not. Prostatitis was slightly less likely to develop in patients who received an enema before the procedure (P = 0.061). Cultures were positive in eight patients with prostatitis, with Escherichia coli identified in six, Klebsiella pneumoniae in one, and Staphylococcus epidermidis in one specimen. In 85.7 percent of the samples, the isolated gram-negative organisms were fluoroquinolone-resistant.
"Prior fluoroquinolone intake is a significant risk factor behind a rising incidence of acute prostatitis after transrectal prostate biopsy," the authors write.