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 journalArticlepeer-review

69 Scopus citations

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
DOIs
StatePublished - Sep 2002

Keywords

  • Antibiotic prophylaxis
  • Biopsy
  • Ofloxacin
  • Prostate

ASJC Scopus subject areas

  • Urology

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