A Comparative Study of Oral Medication to Prevent
Transient Bacteremia and Adverse Events from
Transrectal Prostatic Biopsy: Ciprofloxacin versus Cefixime
Thuchchai Pipitpanpipit MD*, Pitak Santanirand PhD**, Wisoot Kongchareonsombat MD*
Affiliation :
* Division of Urology, Department of Surgery, Faculty of Medicine,
Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
** Clinical Microbiology Unit, Department of Pathology, Faculty of Medicine,
Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Objective : To study the transient bacteremia and adverse events of changing antibiotic prophylaxis from oral ciprofloxacin
to oral cefixime in (patients) undergoing transrectal prostatic biopsy.
Material and Method: One hundred patients with suspected prostate cancer underwent outpatient surgery at Ramathibodi
Hospital were randomly assigned to two groups. The first group was prescribed oral ciprofloxacin, and the second group
received oral cefixime. Blood culture tests were routinely performed within 24 hours after transrectal prostatic biopsy in
all patients, and they were monitored for adverse reactions over a 14-day period.
Results : Transient bacteremia was detected in 2% of the participants in the group with oral cefixime, and none in the group
receiving oral ciprofloxacin, but the rate of transient bacteremia of the two groups was no varied with statistical significance
(p>0.05). Adverse effects, including acute urinary retention (AUR), hematuria, rectal bleeding, vasovagal syncope, and
hematospermia, were found in both patient groups after the procedure. They did not differ significantly (p>0.05). Dysuria
was found in the group treated with oral cefixime and it differ significantly (p<0.05).
Conclusion : Cefixime is likely not the antibiotic of choice compared with ciprofloxacin in preventing post-transrectal
prostatic biopsy transient bacteremia, and it appears to show a high rate of dysuria after transrectal prostatic biopsy. Until
a more suitable, effective oral prophylactic agent is found, quinolone-based antibiotics should be the antibiotic of choice
for patient undergoing transrectal prostatic biopsy.
Keywords : Antibiotic prophylaxis; transrectal prostatic biopsy; ciprofloxacin; cefixime; transient bacteremia
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