Prostate biopsy infections major concern for urologists

Key Points

In the area of urologic infections and inflammation, research to be presented at this year's AUA annual meeting in Washington will highlight an ongoing trend toward understanding and attempting to modify the human microbiologic environment for patients' benefit.

From a clinical standpoint, a key issue is the risk of post-biopsy infection in men being tested for prostate cancer.

"What's concerning urologists most right now is infections after prostate biopsies," said Anthony J. Schaeffer, MD, professor and chairman of urology at the Northwestern University Feinberg School of Medicine, Chicago.

Because many infectious organisms are quinolone-resistant, Dr. Schaeffer said, physicians often don't know how to approach prophylaxis in patients undergoing TRUS. However, he said one AUA abstract (which he co-authored) represents a significant breakthrough here.

In this study, cultures obtained from rectal swabs performed in a subset of men undergoing TRUS enabled researchers to provide targeted prophylaxis to those at risk of developing ciprofloxacin (Cipro, Proquin)-resistant postoperative infections. Compared to empirical prophylaxis using ciprofloxacin, targeted antimicrobial prophylaxis significantly cut the incidence of post-TRUS infections caused by quinolone-resistant organisms and decreased overall cost of care. Accordingly, he said that his department has adopted this approach as protocol.

"This looks to be a very promising, significant change in practice styles that could be implemented anywhere," he said.