Abstract:
PURPOSE:Rectal culture screening for fluoroquinolone (FQ)-resistant Enterobacteriaceae before transrectal ultrasound guided prostate (TRUSPB) biopsy and targeted antibiotic prophylaxis (TAP) may decrease post-TRUSPB infection rates compared to empiric (EAP) regimens. The objective of this study was to evaluate the effectiveness of targeted relative to empiric prophylaxis regimens on rates of infectious complications after TRUSPB and to determine the baseline prevalence of FQ resistance based on prior rectal swabs. METHODS:An electronic search within literature databases including EMBASE and Web of Science (all databases) for articles assessing TAP as an approach to TRUSPB prophylaxis was conducted. Quality assessment was performed using the Hoy instrument. Meta-analysis was performed using MetaXL 5.3. RESULTS:From 15 studies (eight retrospective and seven prospective) representing 12,320 participants, infectious complication incidence was 3.4% in EAP and 0.8% in TAP patients. The number needed to treat with TAP to avoid one more infection when compared to the EAP group was 39. Effect sizes were homogeneous. Prevalence of FQ resistance showed low (15%) and high (28%) subgroups, likely due to region of origin (within and outside USA, respectively). CONCLUSIONS:Rectal culture prior to TRUSPB and use of TAP adjusts for endemic FQ resistance and is associated with less infectious complications and resulting morbidity when compared to EAP. Overtreatment associated with augmented prophylaxis approaches may be reduced as a result. Further prospective assessment and cost-benefit analyses are required before widespread implementation can be recommended.
journal_name
World J Uroljournal_title
World journal of urologyauthors
Scott S,Harris PN,Williamson DA,Liss MA,Doi SAR,Roberts MJdoi
10.1007/s00345-018-2217-7subject
Has Abstractpub_date
2018-07-01 00:00:00pages
1007-1017issue
7eissn
0724-4983issn
1433-8726pii
10.1007/s00345-018-2217-7journal_volume
36pub_type
杂志文章,meta分析abstract:PURPOSE:Salvage radiotherapy (SRT) for biochemical recurrence (BCR) following radical prostatectomy (RP) should if possible be added at a prostate-specific antigen (PSA) level of <1-2 ng/mL. The value of positron emission tomography combined with computed tomography (PET/CT) at such low PSA values is not defined. The p...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-015-1547-y
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journal_title:World journal of urology
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journal_title:World journal of urology
pub_type: 杂志文章,评审
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pub_type: 杂志文章,评审
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pub_type: 杂志文章,多中心研究
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journal_title:World journal of urology
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journal_title:World journal of urology
pub_type: 杂志文章,meta分析
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pub_type: 历史文章,杂志文章
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journal_title:World journal of urology
pub_type: 杂志文章
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journal_title:World journal of urology
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journal_title:World journal of urology
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journal_title:World journal of urology
pub_type: 杂志文章,多中心研究
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journal_title:World journal of urology
pub_type: 已发布勘误
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pub_type: 杂志文章
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journal_title:World journal of urology
pub_type: 杂志文章,评审
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