Table 1. Measures taken in selected studies to reduce infective complications from prostate biopsy.
| Source | No. | Year | Intervention | Comparator | Measure | Outcome | Level of evidence |
|---|---|---|---|---|---|---|---|
| Batura et al. [16] | 871 | 2014 | Augmented prophylaxis, 1-g amikacin IV immediately beforehand | 500-mg ciprofloxacin for 7 days and 500-mg PR metronidazole afterward | All infective complications | Reduced from 3.9% to 1.4% | 4 |
| Womble et al. [15] | 8,505 | 2015 | Augmented prophylaxis with either gentamicin 120 mg IM or 1- to 2-g cefazolin | Ciprofloxacin 500 mg PO 1 hour before biopsy and again after biopsy | Infection related ospitalizations | Reduced from .19% to 0.57% | 4 |
| Womble et al. [15] | 3,911 | 2015 | Rectal swab culture directed antibiotic prophylaxis | Ciprofloxacin 500 mg PO 1 hour before biopsy and again after biopsy | Infection related hospitalizations | Reduced from 1.19% to 0.47% | 4 |
| Taylor et al. [17] | 457 | 2012 | Rectal swab culture directed antibiotic prophylaxis | Ciprofloxacin PO 500 mg 2 hours prior and 12 hours after biopsy | All infective complications | Reduced from 2.6% to Nil* | 4 |
| Dai et al. [8] | 487 | 2015 | Rectal swab culture directed antibiotic prophylaxis | 3 Doses 500-mg ciprofloxacin before biopsy | All infective complications | Reduced from 2.9% to 1.9%* | 4 |
| Abughosh et al. [11] | 865 | 2013 | povidone-iodine rectal cleansing | Ciprofloxacin 1,000 mg for 3 days prior | Septic complications | Reduced from 1.6% to 1.0%* | 4 |
| Park et al. [19] | 1,684 | 2014 | povidone-iodine suppository, single IV 3rd generation cephalosporin immediately before biopsy and cefixime 100 mg PO for 5 days starting the day of biopsy | Nil | All infective complications | 0.65% | 4 |
| Issa et al. [20] | 2,632 | 2013 | Formaldehyde needle disinfection | 500-mg ciprofloxacin started on day of procedure | Urinary tract infection or sepsis | Reduced from 0.8% to 0.3%* | 4 |
| Koc et al. [21] | 180 | 2010 | povidone-iodine solution to disinfect biopsy needles | 500 mg BD ciprofloxacin started on day of procedure | All infective complications | Reduced from 7.2% to 4.8%* | 2b |
| Grummet et al. [28] | 6,609 | 2014 | Transperineal approach with variable | Nil | Sepsis | 0.08% | 4 |
| Vyas et al. [29] | 634 | 2014 | Transperineal approach with amikacin 500 mg IV at induction and ciprofloxacin 500 mg BD for three days | Nil | Sepsis | Zero | 4 |
| Ghafoori et al. [25] | 180 | 2015 | Twelve core biopsy technique | Eighteen core biopsy technique, with antibiotic prophylaxis | All infectious complications | Reduced from 58.3% to 38.3% | 2b |
| McCormack et al. [26] | 105 | 2012 | 16-G biopsy needle | 18-G biopsy needle with antibiotic prophylaxis | All infective complications | Increased from 3.8% to 4.0%* | 4 |
| Tuncel et al. [23] | 198 | 2008 | Disposable needle guide | Reusable needle guide disinfected with 3.2% glutaraldehyde solution between patients | Acute urinary infection | Reduced from 8.2% to 2.3% | 2b |
| Gurbuz et al. [24] | 55 | 2011 | Disposable needle guide | Reusable needle guide disinfected with 3.2% glutaraldehyde solution between patients | Symptomatic urinary infection | Increased from 3.9% to 4.0%* | 2b |
IV, intravenous; PR, per rectum; IM, intramuscular; PO, per oral; Nil, not described or not available; bd, twice daily.
*Result not statistically significant p<0.05.