Complications following local anaesthetic transperineal prostate biopsies without antibiotic prophylaxis: An institution’s experience
John, Joseph B
Speakman, Mark J
JournalJournal of Clinical Urology
RightsCopyright © 2021, © SAGE Publications
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Objectives:This study aimed to describe a UK institution?s experience with local anaesthetic (LA) transperineal (TP) prostate biopsies (PB), and to report 30-day complications following LATPPB, including a large cohort that did not receive antibiotic prophylaxis.Patients and methods:A prospective database of 313 consecutive patients undergoing LATPPB was maintained, describing patient and disease characteristics, and complications. From September 2019 to January 2020, antibiotic prophylaxis was given before LATPPB (n=149). Following a change to routine care, from January 2020 to July 2020, prophylactic antibiotics were not given before LATPPB (n=164). A comparative analysis was performed to determine complication rates following antibiotic prophylaxis discontinuation using electronic hospital and primary care records.Results:Patient and disease characteristics were comparable in antibiotic and non-antibiotic cohorts, and representative of PB and prostate cancer cohorts described in the urological literature. The infection-related complication rate was 0.32% across all patients, and 0% for those not receiving antibiotic prophylaxis. The overall complication rate was 0.64%, and 0.61% for those not receiving antibiotic prophylaxis. There were no severe (Clavien?Dindo 3?5) complications. The unplanned hospital admission rate was 0.64%.Conclusion:The complication rate after LATPPB was low, with no infection-related complications in patients who did not receive antibiotic prophylaxis. This provides further evidence supporting the discontinuation of routine prophylactic antibiotics before TPPB.Level of evidence: Level 2b.