scholarly journals ANTIBIOTIC PROPHYLAXIS WITH DIFFERENT ANTIBIOTIC REGIMEN IN PROSTATE BIOPSY PATIENTS

2013 ◽  
Vol 20 (1) ◽  
Author(s):  
Dimas Sindhu Wibisono ◽  
Doddy M. Soebadi ◽  
Soetojo Soetojo ◽  
Budiono Budiono
Keyword(s):  
Antibiotic Prophylaxis ◽  
Prostate Biopsy ◽  
Urine Culture ◽  
Blood Levels ◽  
Positive Urine Culture ◽  
Blood Leukocytes ◽  
Biopsy Material ◽  
Reactive Protein ◽  
Significant Difference ◽  
Blood Leukocyte

Objective: To know the incidence of urinary tract infection (UTI) with different antibiotic prophylaxis for transrectal ultrasonography (TRUS) prostate biopsy. Material & Method: The study included 34 patients at Soetomo Hospital Surabaya, who were divided into 2 groups, each group consisting of 17 patients. In the first group patients received 1000 mg of ciprofloxacin orally, in the second group cefotaxime 1000 mg iv was given prior to biopsy. The two groups were compared in terms of UTI incidence as observed from the blood levels of leukocytes, C-reactive protein (CRP) and urine culture 3 days after the procedure. Results: Based on blood leukocyte levels, there was no statistically significant difference between the two groups (p = 0,74 and p = 0,42). So was the comparison of CRP levels. There was no other significant difference found (p = 0,53 and p = 0,27). From the results of urine culture, the ciprofloxacin group had positive urine culture results lower than the cefotaxime group (29,4% : 35,3%), although it was not statistically significant (p = 1,0). Conclusion: Based on the parameters of blood leukocytes levels, CRP and urine culture, there were no differences in the incidence of UTI after biopsy in the two groups.Keywords: TRUS prostate biopsy, UTI, ciprofloxacin, cefotaxime.

scholarly journals Options for antibacterial prophylaxis of infectious complications of prostate biopsy

2021 ◽  
Vol 14 (3) ◽  
pp. 150-155
Author(s):  
S.V. Popov ◽  
◽  
I.N. Orlov ◽  
D.Yu. Chernysheva ◽  
T.M. Topuzov ◽  
...  
Keyword(s):  
Antibiotic Prophylaxis ◽  
Prostate Biopsy ◽  
Clinical Guidelines ◽  
Urine Culture ◽  
Infectious Complications ◽  
Antibacterial Prophylaxis ◽  
Scientific Databases ◽  
Transrectal Prostate Biopsy ◽  
Long Time ◽  
Transperineal Biopsy

Introduction. Amount of prostate biopsy procedures rises every year and up to 95% of cases of prostate biopsy is performed via transrectal approach. The incidence of infectious complications of transrectal prostate biopsy reaches up to 17%, while incidence of such complications of transperineal biopsy is about 1%. The majority of international clinical guidelines recommends for obligatory antibiotic prophylaxis prior to prostate biopsy of any approach, but the choice of antibiotic is still debatable. The aim of this review is to sum up the approaches of international urological guidelines to the antibiotic prophylaxis prior to prostate biopsy. Materials and methods. We analyzed the search results in the scientific databases PubMed, Google Scolar, elibrary.ru for the queries «prostate biopsy», «antibacterial prophylaxis» and «guidelines». Results. According to the recommendations of most professional communities, antibacterial prophylaxis of infectious complications of prostate biopsy can be carried out in various ways - once or for a long time, one- or two-component, empirically or on the basis of urine culture on microflora. Conclusion. Despite the differences in the levels of sensitivity and resistance of coliform flora around the world, the clinical guidelines in most countries are uniform in terms of the choice of drugs to reduce the risk of developing infectious complications after prostate biopsy. Approaches to antibacterial prophylaxis after prostate biopsy differ only depending on the type of biopsy access.

Effectiveness of standardized peri-operative protocol with combination of gentamicin and levofloxacin as prophylactic antibiotics on preventing infections after transrectal prostate biopsy: A retrospective study of 577 patients

2021 ◽  
Author(s):  
Heng-Chieh Chiang ◽  
Jesun Lin ◽  
Meng-Yi Yan ◽  
Chun-Chi Chen ◽  
Jian-Ting Chen ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Blood Culture ◽  
Prostate Biopsy ◽  
Urine Culture ◽  
Controlled Trial ◽  
Infectious Complications ◽  
Positive Urine Culture ◽  
Urine Retention ◽  
E Coli ◽  
Positive Urine

Abstract PurposeThis retrospective study to determine the effectiveness standardized peri-operative protocol in combination with prophylactic gentamicin and levofloxacin in preventing infectious complications after trans-rectal prostate biopsy.Material and MethodPatients were screened for prostate cancer at our out-patient department, either due to abnormal digital examination or elevated PSA level. Patients who underwent transrectal ultrasound (TRUS) guided prostate biopsy from January 2008 to December 2012 was included in this study. After using surgical code to identify the patients, charts were reviewed, and complications were recorded. Infectious complications were defined as any patient who experienced any signs systemic inflammatory response syndrome (SIRS) within 14 days after undergoing TRUS biopsy. Complications were graded according to Clavien-Dindo classification.ResultsOut of the 577 patients there were 20 patients (3.47 %) with infectious complications. Of the 20 patients with infectious complications, only four patients (0.7%) needed hospitalization due to bacteremia. Minor complications (i.e., hematuria, acute urine retention, hematospermia, etc.) were self-resolving. There were 9 positive urine culture and 4 positive blood culture with Escherichia coli (E. coli) as the predominant species. Three patients had positive urine culture for ciprofloxacin resistant strain, which was susceptible to 2nd an 3rd generation cephalosporin or amikacin. One patient had blood culture positive for extended-spectrum beta-lactamase (ESBL) E. coli infection, which was sensitive to amikacin. The infectious complication rate and number decrease each year without increase in resistant strain.ConclusionOur current peri-operative and post-operative protocol appears to be feasible in reducing infection complications after prostate biopsy; our complication and sepsis rate were similar compared to other English literatures. A prospective randomized controlled trial would be needed to determine if a single factor or a combination of several factors are responsible for the reduction in post-biopsy infections.

scholarly journals THE EFFECT OF POVIDONE IODINE INTRARECTAL TO REDUCE BACTERIURIA, BACTEREMIA, AND SIRS AFTER TRUS PROSTATE BIOPSY

2018 ◽  
Vol 25 (1) ◽  
Author(s):  
Rifky Aulia ◽  
Fikri Rizaldi ◽  
Sunaryo Hardjowijoto
Keyword(s):  
Urinary Tract ◽  
Bacterial Translocation ◽  
Prostate Biopsy ◽  
Group Treatment ◽  
Povidone Iodine ◽  
Rectal Swab ◽  
Urine Culture ◽  
Transrectal Ultrasound ◽  
Prophylactic Antibiotic ◽  
Significant Difference

Objective: To compare the incidence of bacteruria, bacteremia, and Systemic Inflammatory Response Syndrome (SIRS) after Transrectal Ultrasound (TRUS) of prostate biopsy for the patients whom given intrarectal povidone iodine, enema, prophylactic antibiotic with given enema and prophylactic antibiotic. Material & Methods: A Randomised, experimental study, 20 samples of men with suspicious of prostate cancer were divided into two groups, first group (control) were given enema (dulcolax supp 10 mg) and prophylactic antibiotic (ciprofloxacin 1000 mg), second group (treatment) were given enema (dulcolax supp 10 mg) prophylactic antibiotic (ciprofloxacin 1000 mg), and intrarectal povidone iodine befotre TRUS of prostate biopsy. Urine and rectal swab culture examination were performed before biopsy then urine, blood culture, and blood leucocyte 2 days after biopsy. To assess any bacterial translocation from rectum to urinary tract, we match the post biopsy urine culture antibiogram and rectal swab culture antibiogram before biopsy. Complications and serious adverse effects were also monitored. Outcomes were assessed using Unpaired T Test and Mann Whitney depends on the data distribution and homogeneity. Results: There was no significant difference bacteriuria between groups (p=0.26). Bacteremia and SIRS were not found within two groups 2 days after prostate biopsy.  Post biopsy bacteriuria positive patients antibiogram were compared with pre biopsy swab rectal culture antibiogram, there was no significant difference between two groups. But, significant correlation of pre biopsy rectal swab culture with post biopsy urine culture (p=0.04) were noted. Conclusion: Intrarectal povidone iodine before TRUS of prostate biopsy were not needed as part of rectal preparation, since enema and prophylactic antibiotic was proven to decrease the incidence of bacteriuria, bacteremia, and SIRS after TRUS of prostate biopsy. The occurrance of bacteriuria were caused by bacterial translocation from rectum to urinary tract.

scholarly journals The first experience of transperineal prostate biopsy without antibiotic prophylaxis

2021 ◽  
Vol 17 (2) ◽  
pp. 46-52
Author(s):  
D. Yu. Chernysheva ◽  
S. V. Popov ◽  
I. N. Orlov ◽  
A. V. Tsoy ◽  
V. A. Neradovskiy
Keyword(s):  
Antibiotic Prophylaxis ◽  
Prostate Biopsy ◽  
Soft Tissues ◽  
Urine Culture ◽  
Randomized Study ◽  
Control Group ◽  
Antibacterial Prophylaxis ◽  
Safe Alternative ◽  
Transperineal Prostate Biopsy ◽  
Complications Rate

Objective: to study the safety of omitting the antibiotic prophylaxis before transperineal prostate biopsy.Materials and methods. The prospective randomized study included data, obtained during the diagnostical process of 85 patients, who underwent transperineal prostate biopsy in 2020. In the control group (n = 50) patients received 1 g Ceftriaxone IV 1 h before the biopsy. In the study group (n = 35) biopsy was performed without previous antibacterial prophylaxis. Age median was 63.2 (52-75) years.Results. No significant differences in the infection complications rate (UTI, soft tissues infections, prostatitis, fever, sepsis) were obtained between the groups. No patient developed UTI, prostatitis or sepsis, confirmed with urine culture.Conclusion. Performing transperineal prostate biopsy without antibiotic prophylaxis seems to be a safe alternative to common prophylaxis regiments, dedicated to infection complications prevention after prostate biopsy.

scholarly journals Asymptomatic bacteriuria: Impact of an antimicrobial stewardship bundle to reduce unnecessary antibiotics in patients without urinary catheters

2021 ◽  
Author(s):  
Matthew Rico ◽  
Rand Sulaiman ◽  
Rachel MacLeod
Keyword(s):  
Antimicrobial Stewardship ◽  
Primary Outcome ◽  
Antimicrobial Agents ◽  
Urine Culture ◽  
Asymptomatic Bacteriuria ◽  
Urinary Catheters ◽  
Positive Urine Culture ◽  
Significant Difference ◽  
Quasi Experimental ◽  
The Difference

Abstract Purpose The purpose of this study was to evaluate the effect of an antimicrobial stewardship bundle on the management of asymptomatic bacteriuria (ASB). Methods In this quasi-experimental study, patients were selected by retrospective, consecutive sampling of patients with a positive urine culture report in 3 separate groups: preintervention, postdiagnostic intervention, and posteducation. Patients met the prespecified criteria for non–catheter-associated ASB. The diagnostic intervention involved a new urinalysis/urine culture ordering process in place of urinalysis with reflex to urine culture. Additionally, an educational intervention involved pharmacist-led sessions to educate providers with patient cases and guideline-based recommendations. The primary outcome of this study was the difference in the rate of inappropriate management of ASB, defined as the use of antimicrobial agents intended to treat ASB. Secondary outcomes included length of antimicrobial therapy, length of stay, and change in urine culture orders per 1,000 patient-days. Results A total of 120 patients were included. There was a significant reduction in the inappropriate management of ASB between the preintervention and postdiagnostic intervention groups (P = 0.0349). This was not seen when comparing the postdiagnostic intervention and posteducation groups (P = 0.93). Additionally, there was a significant difference in urinalysis/urine culture ordering between the preintervention and postdiagnostic intervention groups (370 vs 224 urinalysis orders per 1,000 days present, P < 0.0001; 131 vs 54 urine culture orders per 1,000 days present, P < 0.0001). Conclusion An antimicrobial stewardship bundle involving a diagnostic stewardship intervention and pharmacist-led education reduced treatment of ASB in patients without urinary catheters.

scholarly journals THE DIFFERENCE OF PAIN PERCEPTION BETWEEN KETOPROFEN SUPPOSITORY AND 1% PERIPROSTATIC LIDOCAINE INJECTION

2012 ◽  
Vol 19 (2) ◽  
Author(s):  
Abdul Azis ◽  
Wahjoe Djatisoesanto ◽  
Doddy M. Soebadi ◽  
Lukman Hakim ◽  
Budiono Budiono
Keyword(s):  
Pain Score ◽  
Visual Analog Scale ◽  
Prostate Biopsy ◽  
Pain Perception ◽  
Prostate Volume ◽  
Pearson Correlation ◽  
Analog Scale ◽  
Biopsy Material ◽  
Significant Difference ◽  
Lidocaine Injection

Objective: To compare the pain control results of ketoprofen suppository and periprostatic injection of lidocaine 1% for prostate biopsy. Material & Method: A total of 30 patients who underwent transrectal ultrasound guided prostate biopsy were randomized into 2 groups. Group 1 consisted of 15 patients received 200 mg of ketoprofen suppository. Group 2 received 1% periprostatic lidocaine injection. A visual analog scale was used to assess the pain score during prostate biopsy. Statistical analysis of pain scores was performed using independent t-test and Pearson correlation test. Results: The 2 groups were homogenous in age and prostate volume. There was significant difference in pain score among groups 1 and 2 during prostate biopsy (mean VAS ± SD 0,8 ± 0,8 and 4,5 ± 1,6 respectively, p < 0,0001). There was no significant correlation between pain perception with age (p = 0,779), or prostate volume (p = 0,389) in both groups. Conclusion: Periprostatic lidocaine injection is more effective for decreasing the pain for prostate biopsy compared to ketoprofen suppository. Keywords: Prostate biopsy, pain, transrectal ultrasonography, periprostatic nerve block, visual analog scale.

scholarly journals PERIPROSTATIC NERVE BLOCK AND INTRAPROSTATIC INFILTRATION ON TRUS-P GUIDED BIOPSY

2013 ◽  
Vol 20 (2) ◽  
Author(s):  
Wendi Rachman ◽  
Ferry Safriadi
Keyword(s):  
Nerve Block ◽  
Prostate Biopsy ◽  
Transrectal Ultrasound ◽  
Anorectal Abscess ◽  
Biopsy Material ◽  
Bladder Pain ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Periprostatic Nerve Block

Objective: This study is aimed to determine the effectiveness and complications of periprostatic block and intraprostatic infiltration anesthesia for transrectal prostate biopsy. Material & Method: Two consecutive group of patients, periprostatic block (group A) and intraprostatic infiltration (group B), underwent transrectal ultrasound (TRUS) guided prostate biopsy were entered into the study. Exclusion criteria were severe systemic infection, local infection (prostatitis, proctitis, anorectal abscess, and fissure), hemorrhoid (external and/or internal), and chronic pelvic pain (bladder pain syndrome (BPS) or other pelvic disease. Each group enrolled 58 patients. The patients were requested to choose indicate degree of pain on visual analog score (VAS) 3 times, during probe insertion (VAS1), during anesthesia (VAS2), and during the biopsy (VAS3). Complications from the procedures were recorded. The data were analyzed using Mann-Whitney and independent t-test. Results: There were no significant difference in average age of groups, 65,69 ± 7,019 years for group A and 65,34 ± 7,633 years for group B (p = 0,647). The VAS3 score of group B 5,17 ± 0,653 was significantly lower than group A 5,9 ± 0,612 (p < 0,001). The change in VAS score (VAS3-VAS2) in group B 0,55 ± 0,535 also significantly lower than group A 1,00 ± 0,530 (p = 0,004). The average days with pain were not significant on both group, group A 1,16 ± 0,362 day and group B 1,12 ± 0,329 day (p = 0,594). The duration of bleeding was significantly higher on group B 1,32 ± 0,562 day than group A 1,10 ± 0,307 day (p = 0,026). Conclusion: Intraprostatic infiltration resulted in less pain during prostate biopsy, but also reported more bleeding after the procedure than the periprostatic block.Keywords: Intraprostatic infiltration, periprostatic nerve block, transrectal ultrasound guided prostate biopsy.

scholarly journals Evaluation of Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and C-Reactive Protein in Tension-Type Headache Patients

2021 ◽  
Author(s):  
Hasan Hüseyin Özdemir ◽  
Ahmet Dönder
Keyword(s):  
Systemic Inflammation ◽  
Tension Type Headache ◽  
Neutrophil To Lymphocyte Ratio ◽  
Control Group ◽  
C Reactive Protein ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Reactive Protein ◽  
Significant Difference ◽  
Type Headache

Abstract Objectives A tension headache is the most common type of headache, and its causes are multifactorial. A relationship has been shown between migraine headaches and neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and C-reactive protein (CRP). In this study, we investigated the NLR, PLR, and serum CRP levels in frequent episodic tension-type headache (FETTH) and chronic tension-type headache (CTTH) patients. Materials and Methods This retrospective study included 64 patients with FETTH, 80 patients with CTTH, and 60 healthy controls who were followed up in the neurology clinic. Hematological parameters were compared between the patient and control groups. Results In CTTH patients, platelets, NLR, PLR, and CRP values were statistically higher than in FETTH patients and patients in the control group. In FETTH patients, the PLR value was higher than in patients in the control group, but there was no statistically significant difference in NLR and CRP values between FETTH patients and patients in the control group. Also, there was no correlation between these values and age and gender. Conclusion Increase platelet count might have an effect on tension-type headache pathophysiology. Systemic inflammation parameters were shown to be significantly higher in CTTH patients. More comprehensive studies are needed to evaluate the effect of systemic inflammation on the chronicity of tension headaches.

scholarly journals Blood Micronutrient and Thyroid Hormone Concentrations in the Oldest-Old

2000 ◽  
Vol 85 (6) ◽  
pp. 2260-2265 ◽  
Author(s):  
Giovanni Ravaglia ◽  
Paola Forti ◽  
Fabiola Maioli ◽  
Barbara Nesi ◽  
Loredana Pratelli ◽  
...  
Keyword(s):  
Thyroid Hormone ◽  
Thyroid Hormones ◽  
Oldest Old ◽  
Serum Zinc ◽  
Blood Levels ◽  
Elderly Age ◽  
Blood Concentrations ◽  
Significant Difference ◽  
Plasma Retinol ◽  
Age Range

Several micronutrients are involved in thyroid hormone metabolism, but it is unclear whether their marginal deficits may contribute to the alterations in thyroid function observed in extreme aging. The relationships among blood concentrations of thyroid hormones and selenium, zinc, retinol, and α-tocopherol were studied in 44 healthy Northern Italian oldest-old subjects (age range, 90–107 yr), selected by the criteria of the SENIEUR protocol. Control groups included 44 healthy adult (age range, 20–65 yr) and 44 SENIEUR elderly (age range, 65–89 yr) subjects. Oldest-old subjects had higher TSH (P &lt; 0.01) and lower free T3 (FT3)/freeT4 (FT4) ratio, zinc, and selenium serum values (P &lt; 0.001) than adult and elderly control subjects. No significant difference was found for plasma retinol and α-tocopherol values. The associations between micronutrients and thyroid hormones were evaluated by multivariate analysis. In oldest-old subjects, plasma retinol was negatively associated with FT4 (P = 0.019) and TSH serum levels (P = 0.040), whereas serum zinc was positively associated with serum FT3 (P = 0.010) and FT3/FT4 ratio (P = 0.011). In younger subjects, no significant association was found among thyroid variables and micronutrients. In conclusion, blood levels of specific micronutrients are associated with serum iodothyronine levels in extreme aging.

scholarly journals Radiologically Inserted Gastrostomy (RIG) at a Tertiary Center: Periprocedural Safety including Rationalization of Antibiotic Prophylaxis

2021 ◽  
Author(s):  
Warren Clements ◽  
Yasmin Shvarts ◽  
Jim Koukounaras ◽  
Tuan D. Phan ◽  
Gerard S. Goh ◽  
...  
Keyword(s):  
Antibiotic Prophylaxis ◽  
Gastric Wall ◽  
Intravenous Sedation ◽  
Minor Bleeding ◽  
Endoscopic Gastrostomy ◽  
Peristomal Infection ◽  
Tertiary Teaching ◽  
Tertiary Center ◽  
Significant Difference ◽  
Wall Injury

Abstract Introduction Long-term percutaneous enteral nutrition forms an important part of treatment for patients with an inability to meet nutrient requirements orally. Radiologically inserted gastrostomy (RIG) is an alternative to the traditionally performed percutaneous endoscopic gastrostomy technique. However, there is marked heterogeneity in the way that RIG is performed. In addition, the role for antibiotic prophylaxis during RIG insertion is not clearly established. This study aimed to assess the safety of RIG insertion using our technique including the role of antibiotics in RIG insertion. Method Retrospective study over 5 years at a tertiary teaching hospital. Periprocedural or early complications within the first 2 weeks of the procedure were collected and correlated with the use of prophylactic antibiotics. Results A total of 116 patients met the inclusion criteria. 18-French tube was used in 96.6%. Note that 58.6% of procedures were done with intravenous sedation. Prophylactic 1 g cefazolin was used in 70 patients with 1 case of infection. Procedures were performed without antibiotics in 46 patients with 3 infections, p = 0.20.There were two major complications (1.7%) consisting of right gastric artery injury requiring embolization and gastric wall injury requiring laparotomy. There were 12 minor complications (10.3%) including 4 cases of infection, 3 of severe pain, 1 of minor bleeding, 2 of early dislodgement, and 2 of leak/bypass of gastric contents around the tube. Conclusion The technique used for RIG insertion at our institution results in a low complication rate. In addition, this study shows no significant difference in early peristomal infection rate with the use of antibiotic prophylaxis.

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