Single dose levofloxacin prophylaxis for prostate biopsy in patients at low risk

Brian C. Griffith, Allen F. Morey, Mustafa M. Ali-Khan, Edith Canby-Hagino, John P. Foley, Thomas A Rozanski

Research output: Contribution to journalArticle

68 Citations (Scopus)

Abstract

Purpose: We determine if a single 500 mg. oral tablet of levofloxacin represents adequate prophylaxis for patients at low risk who undergo transrectal prostate biopsy. Materials and Methods: From April 2000 to May 2001 we prospectively evaluated 400 consecutive men who underwent transrectal needle biopsy of the prostate after a single 500 mg. oral dose of levofloxacin. Under an institutional review board approved protocol the drug was issued under a standing order by a clinic nurse 30 to 60 minutes before the procedure. Patients were issued 2 additional daily doses of levofloxacin if they were deemed at increased risk for infectious complications, that is if they had a large prostate more than 75 cc, diabetes mellitus, recent steroid use, severe voiding dysfunction or immune compromise. No patient received a cleansing enema before the procedure. Complications, the number of biopsy cores, prostate size and cancer detection rates were assessed. Results: Only 1 of the 377 patients at low risk in whom biopsy was completed experienced a symptomatic urinary tract infection (0.27%). None of the 23 men at high risk who received additional doses of levofloxacin experienced a complication. Thus, the overall infection rate was 1 of 400 cases (0.25%) in this series. A mean of 7 biopsy cores (range 2 to 16) was obtained per patient and mean prostate volume was 49.75 cc (range 12 to 150). Prostate cancer was present in 93 patients (23%). Conclusions: A single 500 mg. dose of levofloxacin before transrectal needle biopsy of the prostate is effective and safe in patients at low risk. The administration of prophylaxis by a clinic nurse under a standing order optimizes patient compliance and physician efficiency. In patients at higher risk for infection additional antibiotic administration appears to provide adequate prophylaxis.

Original languageEnglish (US)
Pages (from-to)1021-1023
Number of pages3
JournalJournal of Urology
Volume168
Issue number3
StatePublished - Sep 2002

Fingerprint

Levofloxacin
Prostate
Biopsy
Needle Biopsy
Prostatic Neoplasms
Nurses
Enema
Research Ethics Committees
Patient Compliance
Infection
Urinary Tract Infections
Tablets
Diabetes Mellitus
Steroids
Anti-Bacterial Agents
Physicians

Keywords

  • Antibiotic prophylaxis
  • Biopsy
  • Ofloxacin
  • Prostate

ASJC Scopus subject areas

  • Urology

Cite this

Griffith, B. C., Morey, A. F., Ali-Khan, M. M., Canby-Hagino, E., Foley, J. P., & Rozanski, T. A. (2002). Single dose levofloxacin prophylaxis for prostate biopsy in patients at low risk. Journal of Urology, 168(3), 1021-1023.

Single dose levofloxacin prophylaxis for prostate biopsy in patients at low risk. / Griffith, Brian C.; Morey, Allen F.; Ali-Khan, Mustafa M.; Canby-Hagino, Edith; Foley, John P.; Rozanski, Thomas A.

In: Journal of Urology, Vol. 168, No. 3, 09.2002, p. 1021-1023.

Research output: Contribution to journalArticle

Griffith, BC, Morey, AF, Ali-Khan, MM, Canby-Hagino, E, Foley, JP & Rozanski, TA 2002, 'Single dose levofloxacin prophylaxis for prostate biopsy in patients at low risk', Journal of Urology, vol. 168, no. 3, pp. 1021-1023.
Griffith BC, Morey AF, Ali-Khan MM, Canby-Hagino E, Foley JP, Rozanski TA. Single dose levofloxacin prophylaxis for prostate biopsy in patients at low risk. Journal of Urology. 2002 Sep;168(3):1021-1023.
Griffith, Brian C. ; Morey, Allen F. ; Ali-Khan, Mustafa M. ; Canby-Hagino, Edith ; Foley, John P. ; Rozanski, Thomas A. / Single dose levofloxacin prophylaxis for prostate biopsy in patients at low risk. In: Journal of Urology. 2002 ; Vol. 168, No. 3. pp. 1021-1023.
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abstract = "Purpose: We determine if a single 500 mg. oral tablet of levofloxacin represents adequate prophylaxis for patients at low risk who undergo transrectal prostate biopsy. Materials and Methods: From April 2000 to May 2001 we prospectively evaluated 400 consecutive men who underwent transrectal needle biopsy of the prostate after a single 500 mg. oral dose of levofloxacin. Under an institutional review board approved protocol the drug was issued under a standing order by a clinic nurse 30 to 60 minutes before the procedure. Patients were issued 2 additional daily doses of levofloxacin if they were deemed at increased risk for infectious complications, that is if they had a large prostate more than 75 cc, diabetes mellitus, recent steroid use, severe voiding dysfunction or immune compromise. No patient received a cleansing enema before the procedure. Complications, the number of biopsy cores, prostate size and cancer detection rates were assessed. Results: Only 1 of the 377 patients at low risk in whom biopsy was completed experienced a symptomatic urinary tract infection (0.27{\%}). None of the 23 men at high risk who received additional doses of levofloxacin experienced a complication. Thus, the overall infection rate was 1 of 400 cases (0.25{\%}) in this series. A mean of 7 biopsy cores (range 2 to 16) was obtained per patient and mean prostate volume was 49.75 cc (range 12 to 150). Prostate cancer was present in 93 patients (23{\%}). Conclusions: A single 500 mg. dose of levofloxacin before transrectal needle biopsy of the prostate is effective and safe in patients at low risk. The administration of prophylaxis by a clinic nurse under a standing order optimizes patient compliance and physician efficiency. In patients at higher risk for infection additional antibiotic administration appears to provide adequate prophylaxis.",
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