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EAU 2018: Efficacy and Safety of Different Dosages of Phosphomycin as Antimicrobial Prophylaxis in Transrectal Biopsy of the Prostate

Copenhagen, Denmark (UroToday.com) Dr. D’Elia, a clinical urologist from the Bolzano General Hospital, Dept. of Urology, presented a randomized study evaluating the proper dosage and timing of phosphomycin used as prostate biopsy prophylaxis. Currently, the most commonly used prophylaxis regimen is fluoroquinilone, however there is a rising incidence of bacterial resistance leading to higher morbidity risks in those obtaining a prostate biopsy.

In her study, 332 patients undergoing transrectal ultrasound guided biopsy or fusion biopsy without having taken antibiotics a month prior to the procedure, were randomized into two groups. Group A received two doses of phosphomycin: once within 4 hours from the procedure and a second time 24 hours post-procedure. Group B was given three doses of phosphomycin: the first was about 12 hours before the procedure, the second was within 4 hours and the last was 24 hours after the procedure.

Dr. D’Elia indicated that no significant differences in various prostatitis parameters analyzed were observable between groups A and B. However, protocol A resulted in higher complication rates than that of B, with the most common being light hematuria and fever. Therefore, two doses seemed to overlie with complication and readmission rates following the procedure. Nonetheless, it was concluded that phosphomycin is a safe and efficacious prophylaxis for those undergoing prostate biopsy.

Speaker: Dr. D’Elia

Authors: D'Elia C., Trenti E., Ladurner C., Palermo S., Mian C., Saleh O., Spoladore G., Cai T., Mian P., Pycha A.

Written by: Whitney Zhang, Department of Urology, University of California-Irvine, at the 2018 European Association of Urology Meeting EAU18, 16-20 March, 2018 Copenhagen, Denmark