Infection Rate after Transperineal Prostate Biopsy with and without Prophylactic Antibiotics: Results from a Systematic Review and Meta-Analysis of Comparative Studies. Issue 1 (24th January 2022)

• Record Type: Journal Article
• Authors: Castellani, Daniele; Pirola, Giacomo Maria; Law, Yu Xi Terence; Gubbiotti, Marilena; Giulioni, Carlo; Scarcella, Simone; Wroclawski, Marcelo Langer; Chan, Erica; Chiu, Peter Ka-Fung; Teoh, Jeremy Yuen-Chun; Gauhar, Vineet; Rubilotta, Emanuele
• Is Part Of: Journal of urology. Volume 207:Issue 1(2022)
• Page Start: 25
• Page End: 34
• Publication Date: 2022-01-24
• Subjects: prostatic neoplasms -- biopsy -- sepsis -- urinary tract infections; Genitourinary organs -- Periodicals; Urology -- Periodicals; Urology -- Periodicals; Urologie -- Périodiques; Urologie; 616.6
• DOI: 10.1097/JU.0000000000002251
• Languages: English
• ISSNs: 0022-5347

Abstract

Abstract : Purpose: We performed a systematic review comparing the incidence of infectious complications following transperineal ultrasound-guided prostate biopsy (TPB) in cases utilizing antibiotic prophylaxis (AP) vs cases not utilizing antibiotic prophylaxis (NAP). Materials and Methods: The incidences of complications were pooled using the Cochran-Mantel-Haenszel method with the random effect model and expressed as risk ratio (RR). RR higher than 1 indicates an increased risk of complication in patients undergoing TPB without antibiotics. Statistical significance was set at p <0.05 and 95% CI. Results: A total of 1, 748 papers were retrieved. After the screening process, 8 studies were included in the quantitative analysis (4 retrospective, and 4 prospective and nonrandomized), reporting on 3, 662 patients. A total of 2, 368 patients underwent TPB utilizing AP and 1, 294 underwent TPB utilizing NAP. The pooled rates of post-biopsy fever from 6 available studies reporting this parameter were 0.69% in the AP group and 0.47% in the NAP group (RR: 1.02, 95% CI: 0.02–44.55, p=0.99). The pooled rates of post-biopsy genitourinary infections from 8 available studies reporting this parameter were 0.11% in the AP group and 0.31% in the NAP group (RR: 2.09, 95% CI: 0.54–8.10, p=0.29). The pooled rates of post-biopsy sepsis over 8 studies reporting this parameter were 0.13% in the AP group and 0.09% in the NAP group (RR: 1.09, 95% CI: 0.21–5.61, p=0.92). The pooled rates of post-biopsy readmission for infections over 8 studies reporting this parameter were 0.13% in the AP group and 0.23% in the NAP group (RR: 1.29, 95% CI: 0.31–5.29, p=0.73). Death due to post-biopsy sepsis did not occur in any study. Conclusions: This systematic review found no significant difference in infection rate, fever, sepsis or readmission rate after TPB between those cases utilizing AP and those cases without AP.