In response to a noted increase in the reports of sepsis and infectious complications after prostate biopsies SUNA and the American Urological Association (AUA) collaborated to draft a white paper. An emerging pattern of fluoroquinolone resistant bacteria, lack of evidence-based, standardized regimen for pre-procedural prophylaxis, and a lack of equipment reprocessing guidelines are addressed in this white paper.
Members of the workgroup included Christopher M. Gonzalez, MD, MBA; Timothy Averch, MD; Lee Ann Boyd, MSN, ARNP, CUNP; J. Quentin Clemens, MD, MSCI; Robert Dowling, MD; Howard B. Goldman, MD; Danil V. Makarov, MD, MHS; Vic Senese, RN; and Mary Anne Wasner, BSN, CURN. Among its summary statements, the workgroup noted the following:
- The AUA Best Practice Statement on prophylaxis for prostate biopsy indicates fluoroquinolones or 1st-, 2nd-, or 3rd-generation cephalosporins are the antimicrobials of choice. Single-dose regimens appear to be as effective as those spanning 1- or 3-days.
- Steam sterilization is the preferred method for reprocessing reusable, heat-stable medical devices, including prostate biopsy needle guides; however, high-level disinfection is an acceptable alternative.