ArticleProstate cancer and prostatic diseases2022
EXIT from TRansrectal prostate biopsies (TREXIT): sepsis rates of transrectal biopsy with rectal swab culture guided antimicrobials versus freehand transperineal biopsy.
Article in Prostate cancer and prostatic diseases, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.
- Infectious complications following transperineal prostate biopsy with or without periprocedural antibiotic prophylaxis-a systematic review including meta-analysis of all comparative studies.Prostate cancer and prostatic diseases · 2026Pooled it
- A Cost-Analysis and Micro-Costing Study of the Man Van Project: Comparing Prostate-Specific Antigen Testing Via a Nurse-Led Mobile Service with Primary Care.PharmacoEconomics - open · 2026Article
- The Impact of Antibiotic Prophylaxis on Antibiotic Resistance, Clinical Outcomes, and Costs in Adult Hemato-Oncological and Surgical Patients: A Systematic Review and Meta-Analysis.Antibiotics (Basel, Switzerland) · 2025Review
- Meta Analysis of Efficacy and Safety of Prostate Biopsy: A Comparison Between Transperineal and Transrectal Approach.Urology research & practice · 2025Review
- TRexit is going one step further.Prostate cancer and prostatic diseases · 2024Article
- The transition from transrectal to transperineal prostate biopsy without antibiotic prophylaxis: Cancer detection rates and complication rates.Prostate cancer and prostatic diseases · 2023Article
- Role of Perilesional Sampling of Patients Undergoing Fusion Prostate Biopsies.Life (Basel, Switzerland) · 2023Article
- Protocol of a multicentre randomised controlled trial assessing transperineal prostate biopsy to reduce infectiouscomplications.BMJ open · 2023Article
Corrections and comments
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Authors and funding
11 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTransrectal prostate biopsy (TRUSBx) holds a risk of prostate biopsy related sepsis. We discuss our step-wise strategies aiming to reduce this risk, including targeted antimicrobials and switching to a freehand transperineal approach (FHTPBx). SUBJECTS AND
methodsThis longitudinal cohort study included three groups. Group A underwent TRUSBx with empirical augmented antimicrobial prophylaxis; Group B underwent TRUSBx with targeted antimicrobial prophylaxis, based on rectal-swab cultures/sensitivity; Group C underwent FHTPBx with empirical antimicrobial prophylaxis. Post biopsy sepsis, defined according to the surviving sepsis campaign and confirmed with blood or urinary cultures, were determined and rates between groups were analysed using fisher's exact test.
resultsOf all 1501 patients, 23 developed post biopsy sepsis; Group A (12/609, 2.0%), B (9/403, 2.2%), C (2/489, 0.4%). Targeted antimicrobials did not reduce the risk of post biopsy sepsis following TRUSBx (A vs B, 2.0% vs 2.2%; p = 0.82). Patients with antimicrobial-resistant rectal flora had an increased post biopsy sepsis rate following TRUSBx despite targeted antimicrobials (9.1% vs 1.1%, p = 0.003). Switching to FHTPBx reduced the risk of developing post biopsy sepsis (A vs C, 2% vs 0.4%, p = 0.03; B vs C, 2.2% vs 0.4%, p = 0.03).
conclusionsTargeted antimicrobials based on rectal swab culture failed to reduce the overall risk of post biopsy sepsis, while FHTPBx nearly eliminated this risk. We recommend the use of transperineal prostate biopsies for all patients as the most effective method to reduce the risk of sepsis.
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Registered trials
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