The addition of peri-operative gentamicin with ciprofloxacin reduces infection and sepsis rates post transrectal prostate biopsy.

Objective: Despite the advent of transperineal (TP) biopsy and reduced risk of infective complications, transrectal ultrasound-guided (TRUS) prostate biopsy is still widely performed worldwide. The accepted prophylactic antibiotic is usually a single agent oral fluoroquinolone; however, this approach is beset by growing antibiotic resistance. The aim of this study was to assess whether the addition of intravenous gentamicin (2 mg/kg or at least 160 mg), immediately prior to biopsy, in conjunction with routine ciprofloxacin prophylaxis, reduced infection and sepsis rates post TRUS biopsy. Method: Six hundred fifty-eight patients underwent TRUS biopsy at our center from 2017 to 2022, of whom 648 had data sufficient for analysis. We performed a retrospective analysis focusing on patient demographics (age, BMI, diabetes status), biopsy parameters, and outcomes of sepsis and urinary tract infection . Patients were recorded as developing sepsis if they required hospital admission for intravenous antibiotics. Fisher's exact test was employed for categorical variables, while the Student's Results: The rate of sepsis was 3.9% in the ciprofloxacin-only group, versus 0% in the ciprofloxacin plus gentamicin group ( Conclusion: The administration of 2 mg/kg intravenous gentamicin with oral ciprofloxacin prophylaxis reduces infection and sepsis rates post TRUS biopsy.