THE USE OF PROPHYLACTIC ANTIBIOTICS IN ULTRASOUND-GUIDED TRANSRECTAL PROSTATE BIOPSY

The use of antibiotic prophylaxis for transrectal prostate biopsy sign ificantly reduces the incidence of infective complications, but no rec ommendations exist as to the most appropriate antibiotic regimen, This study was designed to find out which antibiotics were used in differe nt departments and the financial cost of each regimen, A postal survey of 144 hospitals in the UK and Ireland was undertaken, Respondents we re asked the name(s), dose(s), route(s) of administration and timing o f antibiotics given pre and post biopsy, The response rate was 73.6%, Thirteen different antibiotics were used in 48 different regimens, The most commonly used antibiotic was metronidazole (orally or rectally) in 55% of regimens followed by oral ciprofloxacin in 48% and intraveno us gentamicin in 48%, Most regimens (89.7%) contained an oral antibiot ic and 58.6% contained an intravenous antibiotic, The cheapest regimen cost 38.7p/patient and the most expensive pound 21.36/patient, calcul ated according to prices quoted in the British National Formulary, Mar ch 1996, We conclude that there is a lack of standardization in antibi otic prophylaxis for ultrasound-guided transrectal prostate biopsy wit h widely differing costs for the different regimens, A review of the l iterature shows that oral antibiotics are inexpensive, well tolerated and effective at reducing the incidence of urinary tract infection and fever following transrectal prostate biopsy, A regimen is proposed in cluding ciprofloxacin or norfloxacin. The addition of oral metronidazo le is a subject for further study.