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Povidone-iodine rectal cleansing and targeted antimicrobial prophylaxis using rectal swab cultures in men undergoing transrectal ultrasound-guided prostate biopsy are associated with reduced incidence of postoperative infectious complications

  • Urology - Original Paper
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Abstract

Purpose

The aim of this study was to evaluate the effect of povidone-iodine rectal disinfection and targeted antimicrobial prophylaxis in men undergoing transrectal ultrasound-guided prostate biopsy based on rectal swab culture results.

Methods

From January 2011 to December 2015, we studied differences in infectious complications in men who received povidone-iodine rectal disinfection with targeted antimicrobial prophylaxis and those who received empirical prophylaxis before transrectal ultrasound-guided prostate biopsy. Clinical variables including demographics, prior antibiotic, rectal swab culture results, povidone-iodine rectal cleansing, antibiotic prophylaxis, and infectious complications were evaluated. Patients were divided into three groups as follows: Group A received no povidone-iodine rectal cleansing but received empirical antimicrobial prophylaxis; group B received povidone-iodine rectal cleansing and empirical antimicrobial prophylaxis; and group C received povidone-iodine rectal cleansing and targeted antimicrobial prophylaxis.

Results

Patients were divided into group A (n = 192; 13.2 %), group B (n = 579; 39.9 %), or group C (n = 679; 46.8 %). In groups A and B, all patients received fluoroquinolone antimicrobial prophylaxis. Group C patients received targeted antimicrobial prophylaxis according to antibiotic resistance of rectal flora, and 71.1 % of these received fluoroquinolone antimicrobial prophylaxis. Infectious complication rates were 3.6, 2.9, and 1.3 % in group A, group B, and group C, respectively. Incidences of acute prostatitis and bacteremia were significantly lower in group C (p = 0.041 and p = 0.049, respectively) than in the other groups.

Conclusions

In the era of quinolone resistance, the combination of povidone-iodine rectal cleansing and targeted antibiotic prophylaxis may reduce the rate of infectious complications.

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Acknowledgments

This study was supported by a Grant (HCRI 15 007-1) from the Chonnam National University Hwasun Hospital Institute for Biomedical Science.

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Authors and Affiliations

  1. Department of Urology, Chonnam National University Medical School, 160 Baekseo-ro, Dong-gu, Gwangju, 61469, Republic of Korea

    Ji Won Ryu, Seung Il Jung, Ji Hoon Ahn, Eu Chang Hwang, Ho Song Yu, Taek Won Kang, Dong Deuk Kwon & Kwangsung Park

  2. Department of Radiology, Chonnam National University Medical School, Gwangju, Republic of Korea

    Jin Woong Kim

Authors
  1. Ji Won Ryu
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  2. Seung Il Jung
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Corresponding author

Correspondence to Seung Il Jung.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study protocol was reviewed and approved by the institutional review board of the Chonnam National University Hwasun Hospital (IRB approved Protocol: No. CNUHH-2015-158). Informed consent was waived by the board.

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Ryu, J.W., Jung, S.I., Ahn, J.H. et al. Povidone-iodine rectal cleansing and targeted antimicrobial prophylaxis using rectal swab cultures in men undergoing transrectal ultrasound-guided prostate biopsy are associated with reduced incidence of postoperative infectious complications. Int Urol Nephrol 48, 1763–1770 (2016). https://doi.org/10.1007/s11255-016-1394-9

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  • DOI: https://doi.org/10.1007/s11255-016-1394-9

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