Abstract
Introduction:
A pathological diagnosis of prostate cancer is usually made by transrectal ultrasound guided prostate biopsies (TRUSgpb). The risk of infection and sepsis associated with this can be reduced by the use of antibiotics.
Significant steps have been taken by units to reduce the risk of hospital-acquired infections. This includes the rationalisation of antibiotic use. Clostridium Difficile can be caused by the use of Ciprofloxacin especially in the elderly patient with significant co-morbidities.
We retrospectively reviewed our sepsis and bacteriuria rates for prostate biopsies, to see it this change in regimen had had any effect.
Methods:
We reviewed data from 377 patients from January 2009 to July 2010 who were seen in our TRUSgpb clinic. Of these 241 underwent a standardised TRUSgpb biopsy. The patients (n = 110) were initially covered with (500 mg) Ciprofloxacin until July 2009, then (n = 64) oral (625 mg) Co-Amoxiclav until December 2009 then (n = 67) IV (1.2g) Co-Amoxiclav until July 2010.
Results:
None of the patients in the Ciprofloxacin group developed sepsis, whilst 9% patients were admitted with sepsis in the oral Co-Amoxiclav and 6% were admitted in the IV Augmentin group. None of the patients in the Ciprofloxacin group were found to have bacteriuria, whilst 11% patients in the oral Co-Amoxiclav and 6% in the IV Co-Amoxiclav group were found to have bacteriuria.
Conclusion:
The use of Co-Amoxiclav has increased the bacteriuria and sepsis rates associated with TRUSgpb when compared to Ciprofloxacin.