Chulalongkorn Medical Journal


Objectives : To study the effectiveness of antibiotic drug use for the treatment of sepsisafter transrectal ultrasound guide core biopsy of prostate (TRUS-Bx).Methods : This was a retrospective study from January 2004 to December 2008 of allmen who received TRUS-Bx at the Department of Urology, King ChulalongkornMemorial Hospital, for the elevation of prostatic specific antigen (PSA > 4.0ng/ml) or abnormal digital rectal examination (DRE). A total of 1,246 patientsunderwent TRUS-Bx developed fever that required hospitalization forantibiotic treatment; 27 patients (2.17%). We excluded 11 patients fromthe study because no organism was identified from their urine or bloodcultures. We recorded and the demographic data as follows: age, PSA,biopsy core, organism and antibiotic susceptibility, bacteriuria, bacteremiaand underlying disease.Results : We detected bacteria from urine or blood culture from 16 patients among atotal of 27 who had fever after TRUS-Bx. The mean age was 65.5 years old(54 - 85 yr), the mean PSA was 11.19 ng/ml (5-42); their mean of biopsycores was 9.06 (6 -12). We found bacteriuria in 13 patients (81.25%), andbacteremia in 6 patients (37.5%). There were 3 patients showing positiveculture in blood and urine; 3 had positive culture in blood only. E. coli wasfound in all positive cultures and every sample resisted to ciprofloxacin whichwas the most commonly use antibiotic for prophylaxis at our institute.However, all cases were sensitive to meropenem, imipenem and amikacin.Conclusion : The study shows that E.coli is the principle organism causing TRUS-sepsisand all of them resisted to ciprofloxacin. However, we found meropenem,imipenem and amikacin sensitive to all cases. They are therefore antibioticsof choice for treatment TRUS-sepsis.


Faculty of Medicine, Chulalongkorn University

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