Korean J Urol.  2011 Apr;52(4):289-292.

Efficacy of Combination Use of Beta-Lactamase Inhibitor with Penicillin and Fluoroquinolones for Antibiotic Prophylaxis in Transrectal Prostate Biopsy

• Shigemura
• Matsumoto
• Tanaka K
• Yamashita
• Arakawa S
• Fujisawa M

Abstract

PURPOSE
To investigate the efficacy of tazobactam/piperacillin (TAZ/PIPC) plus levofloxacin (LVFX) as a prophylactic administration in transrectal prostate biopsy (TPBX).
MATERIALS AND METHODS
We investigated 201 consecutive patients who underwent TPBX in one Japanese hospital during the period of 2009-2010. The patients received TAZ/PIPC 4.5 g i.v. once just before and 3 hours after TPBX, plus oral LVFX 300 mg or 500 mg daily for 3 days. We examined the infectious adverse events and laboratory data (serum white blood cell [WBC] count and C-reactive protein [CRP]) before and 1 day after TPBX.
RESULTS
Only one patient (0.50%) in 201 cases had febrile complications after TPBX. Serum WBC and CRP did not rise significantly on the day after TPBX compared with before TPBX (p>0.05). There was no significant difference in the rise of serum WBC and CRP before and after TPBX in the comparison of LVFX 500 mg with LVFX 300 mg in the TAZ/PIPC plus LVFX regimen.
CONCLUSIONS
TAZ/PIPC plus LVFX can be considered as a prophylactic regimen for preventing infectious complications in TPBX.

Keyword

Antibiotic prophylaxis; Biopsy; Infection

MeSH Terms

Antibiotic Prophylaxis
Asian Continental Ancestry Group
beta-Lactamases
Biopsy
C-Reactive Protein
Fluoroquinolones
Humans
Leukocytes
Ofloxacin
Penicillins
Prostate
C-Reactive Protein
Fluoroquinolones
Ofloxacin
Penicillins
beta-Lactamases

Reference

1. Miura T, Tanaka K, Shigemura K, Nakano Y, Takenaka A, Fujisawa M. Levofloxacin resistant Escherichia coli sepsis following an ultrasound-guided transrectal prostate biopsy: report of four cases and review of the literature. Int J Urol. 2008; 15:457–459. PMID: 18452466.

2. Kakehi Y, Naito S. Complication rates of ultrasound-guided prostate biopsy: a nation-wide survey in Japan. Int J Urol. 2008; 15:319–321. PMID: 18380819.

3. Shigemura K, Arakawa S, Miura T, Nakano Y, Tanaka K, Fujisawa M. Significance of fluoroquinolone-resistant Escherichia coli in urinary tract infections. Jpn J Infect Dis. 2008; 61:226–228. PMID: 18503177.

4. Ozden E, Bostanci Y, Yakupoglu KY, Akdeniz E, Yilmaz AF, Tulek N, et al. Incidence of acute prostatitis caused by extended-spectrum beta-lactamase-producing Escherichia coli after transrectal prostate biopsy. Urology. 2009; 74:119–123. PMID: 19464043.

5. Uji T, Hashimoto Y. Pharmacological properties and clinical efficacies of tazobactam/piperacillin (Tazosyn 2.25, Zosyn 4.5), an injectable antibiotic combined with beta-lactamase inhibitor. Nippon Yakurigaku Zasshi. 2009; 133:351–358. PMID: 19521033.

6. Moet GJ, Watters AA, Sader HS, Jones RN. Expanded studies of piperacillin/tazobactam formulations: variations among branded product lots and assessment of 46 generic lots. Diagn Microbiol Infect Dis. 2009; 65:319–322. PMID: 19822271.

7. Matsumoto T. Guidelines for prevention of perioperative infections in urological field. 2006. 1st ed. Tokyo: Koyo-sha;p. 24–26.

8. Shigemura K, Yasufuku T, Yamashita M, Arakawa S, Fujisawa M. Prophylactic use of isepamicin and levofloxacin for transrectal prostate biopsy: a retrospective single center study. Int J Urol. 2009; 16:723–725. PMID: 19638042.

9. Eichler K, Hempel S, Wilby J, Myers L, Bachmann LM, Kleijnen J. Diagnostic value of systematic biopsy methods in the investigation of prostate cancer: a systematic review. J Urol. 2006; 175:1605–1612. PMID: 16600713.

10. Falagas ME, Karageorgopoulos DE. Extended-spectrum beta-lactamase-producing organisms. J Hosp Infect. 2009; 73:345–354. PMID: 19596491.

11. Shigehara K, Miyagi T, Nakashima T, Shimamura M. Acute bacterial prostatitis after transrectal prostate needle biopsy: clinical analysis. J Infect Chemother. 2008; 14:40–43. PMID: 18297448.

12. Drusano GL, Preston SL, Van Guilder M, North D, Gombert M, Oefelein M, et al. A population pharmacokinetic analysis of the penetration of the prostate by levofloxacin. Antimicrob Agents Chemother. 2000; 44:2046–2051. PMID: 10898674.

13. Lugg J, Lettieri J, Stass H, Agarwal V. Determination of the concentration of ciprofloxacin in prostate tissue following administration of a single, 1000 mg, extended-release dose. J Chemother. 2008; 20:213–218. PMID: 18467248.

14. Matsumoto T, Kiyota H, Matsukawa M, Yasuda M, Arakawa S, Monden K. Japanese guidelines for prevention of perioperative infections in urological field. Int J Urol. 2007; 14:890–909. PMID: 17880286.

15. Kato R, Suzuki Y, Matsuura T, Sato K, Shimaya R, Fujishima Y, et al. Septic shock due to fluoroquinolone-resistant Escherichia coli after trans-rectal prostate needle biopsy. Hinyokika Kiyo. 2010; 56:453–456. PMID: 20808065.

16. Sakakibara Y, Takezawa J. Current guideline for hospital infection control in Japan. Nippon Rinsho. 2002; 60:2084–2089. PMID: 12440111.

17. Hori S, Sengupta A, Joannides A, Balogun-Ojuri B, Tilley R, McLoughlin J. Changing antibiotic prophylaxis for transrectal ultrasound-guided prostate biopsies: Are we putting our patients at risk? BJU Int. 2010; 106:1298–1302. PMID: 20518764.

18. Carlson WH, Bell DG, Lawen JG, Rendon RA. Multi-drug resistant E.coli urosepsis in physicians following transrectal ultrasound guided prostate biopsies--three cases including one death. Can J Urol. 2010; 17:5135–5137. PMID: 20398457.

19. Kim SJ, Kim SI, Ahn HS, Choi JB, Kim YS, Kim SJ. Risk factors for acute prostatitis after transrectal biopsy of the prostate. Korean J Urol. 2010; 51:426–430. PMID: 20577611.

20. Aboderin OA, Abdu AR, Odetoyin BW, Lamikanra A. Antimicrobial resistance in Escherichia coli strains from urinary tract infections. J Natl Med Assoc. 2009; 101:1268–1273. PMID: 20070015.

21. Freeman JT, Sexton DJ, Anderson DJ. Emergence of extended-spectrum beta-lactamase-producing Escherichia coli in community hospitals throughout North Carolina: a harbinger of a wider problem in the United States? Clin Infect Dis. 2009; 49:e30–e32. PMID: 19522654.

22. Lee DS, Lee CB, Lee SJ. Prevalence and risk factors for extended spectrum beta-lactamase-producing uropathogens in patients with urinary tract infection. Korean J Urol. 2010; 51:492–497. PMID: 20664784.

23. Shigemura K, Arakawa S, Yamanaka K, Kataoka N, Yuien K, Fujisawa M. Significance of lateral biopsy specimens during transrectal ultrasound-guided prostate biopsies in Japanese men. Int J Urol. 2007; 14:935–938. PMID: 17880293.