Comparison of Infectious Complications After Transrectal Prostate Biopsy Under Two Antibiotic Prophylaxis Regimens: Ceftriaxone Plus Cefixime Versus Ciprofloxacin Plus Gentamicin
Abstract
Objectives: To compare the effectiveness and safety of two antibiotic prophylaxis regimens, ciprofloxacin plus gentamicin and ceftriaxone plus cefixime, in preventing infectious complications after transrectal ultrasound-guided prostate biopsy.
Methods: The study retrospectively reviewed 705 consecutive patients who underwent transrectal ultrasound-guided prostate biopsy between January 2020 and January 2024. Group 1 (n = 374) received ciprofloxacin plus gentamicin, and Group 2 (n = 331) received ceftriaxone plus cefixime. All patients underwent standard rectal preparation with povidone-iodine, and needle-tip disinfection with formalin. The primary outcome was the development of post-biopsy infectious complications, while secondary outcomes included sepsis and infection-related hospitalization.
Results: The two groups were comparable in terms of age, body mass index, prostate-specific antigen levels, and comorbidities. The overall rate of post-biopsy infection was 1.4%, occurring in 1.1% patients in Group 1 and 1.8% patients in Group 2 (p = 0.61). The incidence of complicated urinary tract infection was 0.3% versus 0.9%, and infection-related hospitalization occurred in 0.5% versus 0.3% of patients in Group 1 and Group 2, respectively, with no cases of sepsis observed. In univariable analyses, diabetes mellitus, histopathological chronic prostatitis, and pre-biopsy antibiotic use were not significantly associated with post-biopsy infection.
Conclusion: The combination of…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 705 participants or records.
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