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Prostate biopsy antibiotic regime 'put patients at risk'

Patients having prostate biopsies who were given a new antibiotic regime designed to control hospital-acquired infections were placed at risk of ‘potentially serious infective complications', researchers report.

Using the new antibiotic regime increased risk of infection over the four weeks after biopsy by five-fold compared with the previous treatment, according to a study published in this month's British Journal of Urology International.

Researchers examined records of 709 patients who received transrectal ultrasound-guided prostate biopsy surgery at Addenbrookes Hospital, Cambridge.

Only 2.4% of patients given the original prophylactic regime of ciprofloxacin developed an infective complication within four weeks of biopsy, compared with 12.9% under the new regime of co-amoxyclav and gentamicin.  Complications under the new regime included 12 cases of sepsis and one of septic shock.

No patient developed C. difficile within the four-week period.

Study author Professor David Neal, surgical oncologist at Addenbrookes Hospital, said:  ‘Understandable concerns about development of hospital-acquired infection led to a new protocol for antibiotic prophylaxis which in turn led to a number of patients being put at increased risk of potentially serious infective complications.'

Professor Chris Butler, a GP in Cardiff and professor of general practice at the University of Cardiff, said: ‘GPs are unlikely to want to use antibiotic regimes that are shown to be inferior. Quinalones are very precious antibiotics. We know resistance develops very quickly to them, and we should be keeping them in reserve.'

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