Considerations and alternative approaches to antibiotic prophylaxis for prostate biopsy

In this study of culture-specific antibiograms from six hospitals in the Philadelphia region, the authors compare American Urological Association (AUA) recommendations for prostate biopsy prophylaxis against the common urinary pathogens, E. coli, Klebsiella, and Proteus.1 The authors examine the sensitivity of these pathogens to the most commonly utilized antibiotics for biopsy prophylaxis, including fluoroquinolones (FQ), trimethoprim/ sulfamethoxazole (TMP/SMX), gentamicin, and ceftriaxone. The results are alarming, with E. coli resistance to FQ and TMP/SMX ranging from 20% to 32%; Klebsiella resistance to FQ and TMP/SMX ranging from 6% to 22%; Proteus resistance to FQ and TMP/SMX ranging from 10 to 32%.