• Xiang Wu, Chenbo Yu, Tao Li, Le Lin, Qiong Xu, QingGuo Zhu, Liefu Ye, and Xiangxun Gao.
• Department of Urology, Fujian Provincial Hospital, Provincial Clinical College of Fujian Medical University, Fuzhou, Fujian, PR China.
• Medicine (Baltimore). 2018 Jan 1; 97 (1): e9549.

AbstractTo detect the best antibiotic protocol for prostate biopsy and to assess the potential risk factors postbiopsy in Chinese patients.A total of 1526 patients underwent biopsy were assessed retrospectively. The effect of 3 antibiotic protocols was compared, including fluoroquinolone (FQ) monotherapy, third-generation cephalosporin combined with FQ and targeted antibiotics according to the prebiopsy rectal swab culture result. Postbiopsy infection (PBI) was defined as fever and/or active urinary tract symptoms such as dysuria or frequency with pyuria and/or leucocytosis, sepsis is defined as the presence of clinically or microbiologically documented infection in conjunction with systemic inflammatory response syndrome. The relationship between infections and clinical characteristics of patients was assessed. Data were first picked out in univariate analysis and then enter multivariate logistic regression.Thirty-three (2.2%) patients developed febrile infection. The combination antibiotic prophylaxis could significantly decrease the rate of PBI than FQ monotherapy (1.0% vs 4.0%, P = .000). The infection rate of the targeted antibiotic group was 1.1%, but there was no significant statistic difference compared with FQ alone (P = .349). Escherichia coli was the most predominant pathogen causing infection. Rectal swab revealed as high as 47.1% and 36.0% patients harbored FQ resistant and ESBL-producing organisms, respectively. In univariate analysis, overweight (BMI between 25 and 28 kg/m), obesity (BMI > 28 kg/m), diabetes were picked out as potential risk factors. Obesity remained as risk factor (OR = 12.827, 95% CI: 0.983-8.925, P = .001) while overweight and diabetes were close to significance (P = .052, .053, respectively).The combined cephalosporin with FQ prophylaxis could significantly decrease the risk of infectious complications. Obesity was an independent risk factor for PBI.Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

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