Journal of infection prevention · 2026
Infectious and non-infectious complications associated with transrectal MRI-guided prostate biopsy using an alternative antibiotic regimen with oral cefixime.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Laura Wolff, Mladen Stankovic, Joao Mendes
Аннотация
BACKGROUND: Transrectal prostate biopsy has raised concerns due to potential postbiopsy infections.
OBJECTIVE: This study evaluated infectious and non-infectious complication rates following transrectal biopsy without bowel preparation, using third-generation cephalosporin prophylaxis instead of resource-intensive targeted approaches.
MATERIALS AND METHODS: A single-centre retrospective study included biopsy-naïve patients undergoing MRI-ultrasound fusion-guided transrectal systematic and targeted prostate biopsies under local anaesthesia in an outpatient setting. All patients received third-generation cephalosporin prophylaxis, cefixime. The primary endpoint was the 30-day infectious complication rate, including fever, genitourinary infections, additional antibiotic prescriptions, unscheduled office/emergency visits, hospitalisations, or sepsis. Secondary endpoints were non-infectious complications such as gross haematuria, rectal bleeding, or acute urinary retention.
RESULTS: Data from 336 cases were analysed. No cases of sepsis or positive blood cultures were observed. Infectious complications were uncommon, with fever ≥38°C occurring in 10 patients (2.9%), of whom 6 (1.8%) required hospitalisation. Localised infection, limited to epididymitis, was reported in 5 patients (1.5%) and was managed with additional antibiotics. Overall, 14 patients (4.2%) required unscheduled visits due to complications. Non-infectious complications were infrequent, with haematuria requiring bladder irrigation in 3 patients (0.9%) and acute urinary retention in 2 patients (0.6%). The median pain score during the procedure was 1.8 on a standardised scale.
DISCUSSION: Transrectal prostate biopsy using third-generation cephalosporin prophylaxis was associated with low infectious and non-infectious complication rates, with no sepsis cases reported. These findings highlight the procedure's safety and effectiveness, supporting its continued clinical use without the need for intensive prophylactic measures.
OBJECTIVE: This study evaluated infectious and non-infectious complication rates following transrectal biopsy without bowel preparation, using third-generation cephalosporin prophylaxis instead of resource-intensive targeted approaches.
MATERIALS AND METHODS: A single-centre retrospective study included biopsy-naïve patients undergoing MRI-ultrasound fusion-guided transrectal systematic and targeted prostate biopsies under local anaesthesia in an outpatient setting. All patients received third-generation cephalosporin prophylaxis, cefixime. The primary endpoint was the 30-day infectious complication rate, including fever, genitourinary infections, additional antibiotic prescriptions, unscheduled office/emergency visits, hospitalisations, or sepsis. Secondary endpoints were non-infectious complications such as gross haematuria, rectal bleeding, or acute urinary retention.
RESULTS: Data from 336 cases were analysed. No cases of sepsis or positive blood cultures were observed. Infectious complications were uncommon, with fever ≥38°C occurring in 10 patients (2.9%), of whom 6 (1.8%) required hospitalisation. Localised infection, limited to epididymitis, was reported in 5 patients (1.5%) and was managed with additional antibiotics. Overall, 14 patients (4.2%) required unscheduled visits due to complications. Non-infectious complications were infrequent, with haematuria requiring bladder irrigation in 3 patients (0.9%) and acute urinary retention in 2 patients (0.6%). The median pain score during the procedure was 1.8 on a standardised scale.
DISCUSSION: Transrectal prostate biopsy using third-generation cephalosporin prophylaxis was associated with low infectious and non-infectious complication rates, with no sepsis cases reported. These findings highlight the procedure's safety and effectiveness, supporting its continued clinical use without the need for intensive prophylactic measures.