Transrectal prostatic biopsy (TRUS-PB)
Note: If positive urine culture pre-operatively, institute treatment according to culture and susceptibility results.
Common Pathogens
Enterobacteriaceae
Pseudomonas spp
Enterococcus spp
Oral regimens: (give 1-2h pre-op)
| Regimen(s) of Choice See General Principles and Pre-Op Antibiotic Administration and Intraoperative Antibiotic Administration | ||
|---|---|---|
| Ciprofloxacin | 500mg PO | x 1 pre-op dose |
| or | ||
| Co-trimoxazole | 1 DS tab PO | x 1 pre-op dose |
Moderate risk:
- previous sepsis post prostate biopsy
- antibiotics in last 6 months
- previous urine/blood/rectal culture with ciprofloxacin or co-trimoxazole-resistant organism
- chronic indwelling catheter
- prostate volume 75mL or greater/severe voiding disturbance
- diabetes/chronic corticosteroid use/immunodeficiency
- recent (6 months) international travel (other than to South Asia)
| Regimen(s) of Choice See General Principles and Pre-Op Antibiotic Administration and Intraoperative Antibiotic Administration | ||
|---|---|---|
| [Ciprofloxacin | 500mg PO | x 1 dose (give 1-2h pre-op) |
| or | ||
| Co-trimoxazole] | 1 DS tab PO | x 1 dose (give 1-2h pre-op) |
| PLUS one of: | ||
| [Fosfomycin | 3g PO | x 1 dose (give 1-4h pre-op) |
| or | ||
| Ceftriaxone | 1g IV | x 1 pre-op dose |
| or | ||
| Gentamicin] | 1.5mg/kg IV | x 1 pre-op dose |
High risk:
- recent (6 months) travel to South Asia
- previous urine/blood/rectal culture with ESBL or AmpC organism susceptible only to carbapenems
| Regimen(s) of Choice See General Principles and Pre-Op Antibiotic Administration and Intraoperative Antibiotic Administration | ||
|---|---|---|
| Meropenem | 500mg IV | x 1 dose given immediately pre-op |
| or | ||
| Ertapenem | 1g IM | x 1 dose given 2h pre-op |