Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • News & Views
  • Published:

Sepsis

Prophylactic antibiotic for prostate biopsy: the carbapenem gamble

Nature Reviews Urology volume 14, pages 394–396 (2017)Cite this article

Subjects

Sepsis is an infrequent but serious adverse risk of transrectal ultrasonography-guided prostate biopsy. A new study evaluated whether the use of single-dose ertapenem, a broad-spectrum antibiotic, resulted in increased carbapenem resistance following biopsy. However, physicians need to carefully consider the risks of antibiotic resistance when balancing the benefit of broad-spectrum antibiosis against a 1% risk of sepsis.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

References

  1. Grabe, M., Forsgren, A. & Björk, T. Concentrations of ciprofloxacin in serum and prostatic tissue in patients undergoing transurethral resection. Eur. J. Clin. Microbiol. 5, 211–212 (1986).

    Article  CAS  Google Scholar 

  2. Cussans, A., Somani, B. K., Basarab, A. & Dudderidge, T. J. The role of targeted prophylactic antimicrobial therapy before transrectal ultrasonography-guided prostate biopsy in reducing infection rates: a systematic review. BJU Int. 117, 725–731 (2016).

    Article  CAS  Google Scholar 

  3. Liss, M. A., Kim, W., Moskowitz, D. & Szabo, R. J. Comparative effectiveness of targeted versus empirical antibiotic prophylaxis to prevent sepsis from transrectal prostate biopsy: a retrospective analysis. J. Urol. 194, 397–402 (2015).

    Article  CAS  Google Scholar 

  4. Taylor, A. K. et al. Targeted antimicrobial prophylaxis using rectal swab cultures in men undergoing transrectal ultrasound guided prostate biopsy is associated with reduced incidence of postoperative infectious complications and cost of care. J. Urol. 187, 1275–1279 (2012).

    Article  CAS  Google Scholar 

  5. Bloomfield, M. G., Page, M. J., McLachlan, A. G., Studd, R. C. & Blackmore, T. K. Routine ertapenem prophylaxis for transrectal ultrasound guided prostate biopsy does not select for carbapenem resistant organisms: a prospective cohort study. J. Urol. http://dx.doi.org/10.1016/j.juro.2017.03.077 (2017).

  6. Cerqueira, G. C. et al. Multi-institute analysis of carbapenem resistance reveals remarkable diversity, unexplained mechanisms, and limited clonal outbreaks. Proc. Natl Acad. Sci. USA 114, 1135–1140 (2017).

    Article  CAS  Google Scholar 

  7. Patel, G., Huprikar, S., Factor, S. H., Jenkins, S. G. & Calfee, D. P. Outcomes of carbapenem-resistant Klebsiella pneumoniae infection and the impact of antimicrobial and adjunctive therapies. Infect. Control Hosp. Epidemiol. 29, 1099–1106 (2008).

    Article  Google Scholar 

  8. World Health Organization. Global priority list of antibiotic-resistant bacteria to guide research, discovery, and development of new antibiotics (WHO, 2017).

  9. Davies, J. & Davies, D. Origins and evolution of antibiotic resistance. Microbiol. Mol. Biol. Rev. 74, 417–433 (2010).

    Article  CAS  Google Scholar 

  10. Liss, M. A. et al. American Urological Association white paper on the prevention and treatment of the more common complications related to prostate biopsy update. J. Urol. http://dx.doi.org/10.1016/j.juro.2017.01.103 (2017).

Download references

Author information

Authors and Affiliations

  1. Deepak K. Pruthi and Michael A. Liss are at the Department of Urology, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, Texas 78229, USA.,

    Deepak K. Pruthi & Michael A. Liss

Authors
  1. Deepak K. Pruthi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Michael A. Liss
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Michael A. Liss.

Ethics declarations

Competing interests

The authors declare no competing financial interests.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Pruthi, D., Liss, M. Prophylactic antibiotic for prostate biopsy: the carbapenem gamble. Nat Rev Urol 14, 394–396 (2017). https://doi.org/10.1038/nrurol.2017.73

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/nrurol.2017.73

This article is cited by

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing