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Bovo A, Kwiatkowski M, Manka L, Wetterauer C, Fux CA, Cattaneo M, Wyler SF, Prause L. Comparison of ciprofloxacin versus fosfomycin versus fosfomycin plus trimethoprim/sulfamethoxazole for preventing infections after transrectal prostate biopsy. World J Urol 2024; 42:356. [PMID: 38806739 PMCID: PMC11133158 DOI: 10.1007/s00345-024-05048-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 05/06/2024] [Indexed: 05/30/2024] Open
Abstract
BACKGROUND To evaluate antibiotic prophylaxis in transrectal prostate biopsies due to the recommendation of the European Medicines Agency (EMA): We describe our single center experience switching from ciprofloxacin to fosfomycin trometamol (FMT) alone and to an augmented prophylaxis combining fosfomycin and trimethoprim/sulfamethoxazole (TMP/SMX). METHODS Between 01/2019 and 12/2020 we compared three different regimes. The primary endpoint was the clinical diagnosis of an infection within 4 weeks after biopsy. We enrolled 822 men, 398 (48%) of whom received ciprofloxacin (group-C), 136 (16.5%) received FMT (group-F) and 288 (35%) received the combination of TMP/SMX and FMT (group-BF). RESULTS Baseline characteristics were similar between groups. In total 37/398 (5%) postinterventional infections were detected, of which 13/398 (3%) vs 18/136 (13.2%) vs 6/288 (2.1%) were detected in group-C, group-F and group-BF respectively. The relative risk of infectious complication was 1.3 (CI 0.7-2.6) for group-C vs. group-BF and 2.8 (CI 1.4-5.7) for group-F vs. group-BF respectively. CONCLUSION The replacement of ciprofloxacin by fosfomycin alone resulted in a significant increase of postinterventional infections, while the combination of FMT and TMP/SMX had a comparable infection rate to FQ without apparent adverse events. Therefore, this combined regimen of FMT and TMP/SMX is recommended.
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Affiliation(s)
- Alberto Bovo
- Department of Urology, Cantonal Hospital Aarau, Tellstrasse 25, 5001, Aarau, Switzerland.
| | - Maciej Kwiatkowski
- Department of Urology, Cantonal Hospital Aarau, Tellstrasse 25, 5001, Aarau, Switzerland
- Medical Faculty, University Hospital Basel, Basel, Switzerland
- Department of Urology, Academic Hospital Braunschweig, Brunswick, Germany
| | - Lukas Manka
- Department of Urology, Academic Hospital Braunschweig, Brunswick, Germany
- Department of Urology, Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Potsdam, Germany
| | - Christian Wetterauer
- Medical Faculty, University Hospital Basel, Basel, Switzerland
- Department of Urology, University Hospital Basel, Basel, Switzerland
- Department of Medicine, Faculty of Medicine and Dentistry, Danube Private University, 3500, Krems, Austria
| | - Christoph Andreas Fux
- Department of Infectious Diseases and Hospital Hygiene, Cantonal Hospital Aarau, Aarau, Switzerland
| | - Marco Cattaneo
- Department of Clinical Research, University of Basel, 4001, Basel, Switzerland
| | - Stephen F Wyler
- Department of Urology, Cantonal Hospital Aarau, Tellstrasse 25, 5001, Aarau, Switzerland
- Medical Faculty, University Hospital Basel, Basel, Switzerland
| | - Lukas Prause
- Department of Urology, Cantonal Hospital Aarau, Tellstrasse 25, 5001, Aarau, Switzerland
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Ueda N, Sato M, Mori S, Matsukawa A, Oki Y, Kujime Y, Mizuno R, Horitani H, Yamamoto T, Fukae S, Yoshinaga M, Matsushita M, Akiyama M, Kamido S, Honda A, Nakayama J, Tei N, Miyake O. Lower Dose of 5 mL of 1% Lidocaine is More Suitable than the Conventional 10 mL for Caudal Block in Transrectal Prostate Biopsy: A Retrospective Cohort Study. Adv Urol 2024; 2024:9331738. [PMID: 38389652 PMCID: PMC10881246 DOI: 10.1155/2024/9331738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 02/04/2024] [Accepted: 02/06/2024] [Indexed: 02/24/2024] Open
Abstract
Objectives In Japan, caudal block with 1% lidocaine is commonly used for transrectal prostate biopsy. Although 10 mL of 1% lidocaine is commonly used, the appropriate dosage of 1% lidocaine has not been studied. Our hospital routinely uses two different doses (5 or 10 mL) of 1% lidocaine for caudal block for transrectal prostate biopsy. Herein, we retrospectively evaluated the efficacy and safety of both doses of 1% lidocaine. Methods This retrospective study included 869 patients who underwent transrectal prostate biopsy with caudal block at our hospital. The amount of 1% lidocaine was determined by the day of the week on which the biopsy was performed, and the patient voluntarily chose the day of the biopsy, unaware of the dose of 1% lidocaine used on that day. Pain, anal sphincter tonus, cancer diagnosis rate, and early complications were compared. Results In total, 466 and 403 patients received 5 and 10 mL of 1% lidocaine for a caudal block, respectively. After propensity-score matching for patient characteristics, each group contained 395 patients. The pain score, anal sphincter tonus score, or prostate cancer diagnosis rate were not significantly different between the two groups. However, rectal bleeding was significantly more frequent and severe in the 10-mL than the 5-mL group (p=0.018 and p=0.0036, respectively). The incidence of other complications was not significantly different between the groups. Conclusions Our results suggest that 5 mL of 1% lidocaine may be more suitable than 10 mL for caudal block during transrectal prostate biopsy.
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Affiliation(s)
- Norichika Ueda
- Department of Urology, Toyonaka Municipal Hospital, 4-14-1 Shibahara-cho, Toyonaka, Osaka 560-8565, Japan
| | - Mototaka Sato
- Department of Urology, Toyonaka Municipal Hospital, 4-14-1 Shibahara-cho, Toyonaka, Osaka 560-8565, Japan
| | - Shunsuke Mori
- Department of Urology, Toyonaka Municipal Hospital, 4-14-1 Shibahara-cho, Toyonaka, Osaka 560-8565, Japan
| | - Atsuki Matsukawa
- Department of Urology, Toyonaka Municipal Hospital, 4-14-1 Shibahara-cho, Toyonaka, Osaka 560-8565, Japan
| | - Yuta Oki
- Department of Urology, Osaka Rosai Hospital, 1179-3 Nagasanecho, Kita-ku, Sakai, Osaka 591-8025, Japan
| | - Yuma Kujime
- Department of Urology, Toyonaka Municipal Hospital, 4-14-1 Shibahara-cho, Toyonaka, Osaka 560-8565, Japan
| | - Ryoya Mizuno
- Department of Urology, Toyonaka Municipal Hospital, 4-14-1 Shibahara-cho, Toyonaka, Osaka 560-8565, Japan
| | - Hiromu Horitani
- Department of Urology, Higashiosaka City Medical Center, 3-4-5 Nishiiwata, Higashiosaka, Osaka 587-8588, Japan
| | - Tetsuya Yamamoto
- Department of Urology, Ikeda City Hospital, 3-1-18 Jonan, Ikeda, Osaka 563-8510, Japan
| | - Shota Fukae
- Department of Urology, Hyogo Prefectural Nishinomiya Hospital, 13-9 Rokutanjicho, Nishinomiya, Hyogo 662-0918, Japan
| | - Mitsuhiro Yoshinaga
- Department of Urology, Minoh City Hospital, 5-7-1 Kayano, Minoh, Osaka 562-0014, Japan
| | - Makoto Matsushita
- Department of Urology, Toyonaka Municipal Hospital, 4-14-1 Shibahara-cho, Toyonaka, Osaka 560-8565, Japan
| | - Mai Akiyama
- Department of Urology, Toyonaka Municipal Hospital, 4-14-1 Shibahara-cho, Toyonaka, Osaka 560-8565, Japan
| | - Satoshi Kamido
- Pharmaceuticals and Medical Devices Agency, 3-3-2 Kasumigaseki, Chiyoda-ku, Tokyo 100-0013, Japan
| | - Ayako Honda
- Department of Anesthesiology, Toyonaka Municipal Hospital, 4-14-1 Shibahara-cho, Toyonaka, Osaka 560-8565, Japan
| | - Jiro Nakayama
- Department of Urology, Suita Tokushukai Hospital, 21-1 Senriokanishi, Suita, Osaka 565-0814, Japan
| | - Norihide Tei
- Department of Urology, Toyonaka Municipal Hospital, 4-14-1 Shibahara-cho, Toyonaka, Osaka 560-8565, Japan
| | - Osamu Miyake
- Department of Urology, Toyonaka Municipal Hospital, 4-14-1 Shibahara-cho, Toyonaka, Osaka 560-8565, Japan
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