Antibiotic prophylaxis and prostate biopsy

Objectives: Perioperative antibiotic prophylaxis is considered a safe and valid option from the urologist to prevent infective complications after prostate biopsy procedure. The transrectal approach is the most experienced by European urologists and the prevalence of infective complications from this procedure is increasing. Aim of this mini-review article is to improve the urologist knowledge on the prevention of infective complications after prostate transrectal biopsy. Methods: Recent publications from Medline and Cochrane Library have been collected. Data from the abstracts presented at the EAU and AUA Congresses during the last 5 years have also been analysed. Results: Fluorquinolone and other antibiotics-resistant bacteria prevalence is normally very high. Other strategies of infective complication prevention such as the use of rectal swab microbiological analysis and relative antibiotics/sensitivity test or the rectal enema with antiseptic solutions or the combined use of different antibiotics are thus justified. The number of biopsy cores reduction and the perineal approach still remain valid alternative indirect options. Conclusions: Different innovative prevention strategies can be easily used in daily clinical practice to reduce the risk of infectious complications after transrectal prostate biopsy, although a specific policy should be adequately introduced to obtain optimal effects from the current use of antibiotic prophylaxis strategies, thus reducing the risk of developing life-threatening situations for the patient and antibiotic resistance phenomena.