Povidone-iodine Rectal Cleansing and Targeted Antimicrobial Prophylaxis Using Rectal Swab Cultures in Men Undergoing Transrectal Ultrasound-guided Prostate Biopsy Are Associated with Reduced Incidence of Postoperative Infectious Complications

Overview

Journal Int Urol Nephrol

Publisher Springer

Specialty Nephrology

Date 2016 Aug 7

PMID 27495324

Citations 5

Authors

Ji Won Ryu

Seung Il Jung

Ji Hoon Ahn

Eu Chang Hwang

Ho Song Yu

Taek Won Kang

Dong Deuk Kwon

Kwangsung Park

Jin Woong Kim

Affiliations

Soon will be listed here.

Abstract

Purpose: The aim of this study was to evaluate the effect of povidone-iodine rectal disinfection and targeted antimicrobial prophylaxis in men undergoing transrectal ultrasound-guided prostate biopsy based on rectal swab culture results.

Methods: From January 2011 to December 2015, we studied differences in infectious complications in men who received povidone-iodine rectal disinfection with targeted antimicrobial prophylaxis and those who received empirical prophylaxis before transrectal ultrasound-guided prostate biopsy. Clinical variables including demographics, prior antibiotic, rectal swab culture results, povidone-iodine rectal cleansing, antibiotic prophylaxis, and infectious complications were evaluated. Patients were divided into three groups as follows: Group A received no povidone-iodine rectal cleansing but received empirical antimicrobial prophylaxis; group B received povidone-iodine rectal cleansing and empirical antimicrobial prophylaxis; and group C received povidone-iodine rectal cleansing and targeted antimicrobial prophylaxis.

Results: Patients were divided into group A (n = 192; 13.2 %), group B (n = 579; 39.9 %), or group C (n = 679; 46.8 %). In groups A and B, all patients received fluoroquinolone antimicrobial prophylaxis. Group C patients received targeted antimicrobial prophylaxis according to antibiotic resistance of rectal flora, and 71.1 % of these received fluoroquinolone antimicrobial prophylaxis. Infectious complication rates were 3.6, 2.9, and 1.3 % in group A, group B, and group C, respectively. Incidences of acute prostatitis and bacteremia were significantly lower in group C (p = 0.041 and p = 0.049, respectively) than in the other groups.

Conclusions: In the era of quinolone resistance, the combination of povidone-iodine rectal cleansing and targeted antibiotic prophylaxis may reduce the rate of infectious complications.

Citing Articles

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Transrectal povidone-iodine efficiency in reducing infections occurring after transrectal ultrasound guided biopsy of the prostate.

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Park R, Gyorfi J, Dewan K, Kirimanjeswara G, Clark J, Kaag M Int Urol Nephrol. 2018; 50(9):1563-1568.

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Boehm K, Siegel F, Schneidewind L, Kranz J, Spachmann P, Frank T Front Surg. 2018; 5:2.

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