Effectiveness of augmented prophylaxis with fosfomycin and ciprofloxacin combination for transrectal ultrasound-guided prostate biopsy

Abstract

Objective: We aimed to determine the efficacy of fosfomycin and ciprofloxacin combination on infectious complications in transrectal ultrasound-guided prostate biopsy (TRUGPB) prophylaxis. Methods: Patients who underwent TRUGPB between January 2018 and January 2023 were retrospectively analyzed, and 1109 patients were included in the study. Patients were divided into 2 groups according to the antibiotic prophylaxis used before the procedure: group-1, oral ciprofloxacin 500 mg (2 × 1) 5 days starting 24 hours before biopsy and group-2, oral ciprofloxacin 500 mg (2 × 1) 5 days starting 24 hours before biopsy and oral fosfomycin 3 g single dose the night before biopsy. Results: Evaluation of the antibiotic prophylaxis used by the patients before the biopsy revealed that 323 (29.1%) patients received ciprofloxacin (group 1), and 786 (70.9%) patients received fosfomycin+ciprofloxacin (group 2) prophylaxis. When infectious complications after biopsy were analyzed, 15 patients (1.4%) developed fever, 9 patients (0.8%) developed febrile urinary tract infection (UTI), 9 patients (0.8%) developed afebrile UTI, and4 patients (0.5%) developed sepsis. When infectious complications were compared according to the antibiotic prophylaxis, febrile UTI and sepsis were statistically significantly more common in group 1 (P=.003 and P=.027). Conclusion: In conclusion, adding fosfomycin to ciprofloxacin in TRUGPB prophylaxis effectively prevents post-biopsy infective complications compared to ciprofloxacin prophylaxis alone.