Is there a role for antibiotic prophylaxis in transperineal interstitial permanent prostate brachytherapy?

A. P. Dicker, A. T. Figura, F. M. Waterman, Richard K Valicenti, S. E. Strup, L. G. Gomella

Research output: Contribution to journalArticle

9 Scopus citations

Abstract

Purpose: There are few data to guide the physician on the use of prophylactic antibiotic(s) for prostate brachytherapy. The purpose of this study was to evaluate the symptomatic urinary tract infection (UTI) rate after performing transperineal interstitial permanent prostate brachytherapy (TIPPB) in conjunction with cystoscopy. Materials and Methods: One-hundred twenty-five patients underwent TIPPB and cystoscopy. All patients received intravenous perioperative antibiotic prophylaxis. No postimplant antibiotic medication was prescribed. All patients were evaluated at 1-month follow- up for symptomatic UTI. No screening (U/A, C+S) was performed for asymptomatic patients. Any UTI within 1 month of TIPPB was considered a complication and scored as an infection. Results: Of 125 patients who underwent TIPPB and cystoscopy, one patient (1%) developed a symptomatic UTI. In our study, a one-time perioperative intravenous dose of cefazolin (Ancef(TM)) without additional postoperative antibiotics resulted in an overall symptomatic UTI rate of 1%. Hence, additional postoperative antibiotics may not be warranted, thus providing a cost saving (500 mg of ciprofloxacin orally, two times a day for 5 days at a cost of $44.95) and reducing the potential risk of antibiotic resistance. Conclusions: When cystoscopy is used in conjunction with TIPPB, perioperative antibiotic prophylaxis is recommended. However, due to the low infection rate expected from TIPPB, postimplant antibiotic use is not recommended. As a result of the low infection rate anticipated from TIPPB and cystoscopy, a large multiinstitutional trial is needed to determine the necessity of antibiotic prophylaxis for TIPPB and cystoscopy.

Original languageEnglish (US)
Pages (from-to)104-108
Number of pages5
JournalTechniques in Urology
Volume6
Issue number2
StatePublished - 2000
Externally publishedYes

Keywords

  • Brachytherapy
  • Prophylaxis
  • Prostate
  • Transperineal

ASJC Scopus subject areas

  • Urology

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    Dicker, A. P., Figura, A. T., Waterman, F. M., Valicenti, R. K., Strup, S. E., & Gomella, L. G. (2000). Is there a role for antibiotic prophylaxis in transperineal interstitial permanent prostate brachytherapy? Techniques in Urology, 6(2), 104-108.