- A new study affirms that a single 500-mg dose of levofloxacin (Levaquin) without enema is effective for preventing infection in most patients undergoing transrectal ultrasound (TRUS)-guided prostate biopsy.
- Those at high risk for infection should receive a 3-day regimen.
Why this matters
- Prebiopsy enema is unnecessary, providing no clinically significant advantage.
- Patients undergoing TRUS-guided prostate biopsy (N=420) were randomly allocated into 3 treatment groups:
- Group A received 500 mg levofloxacin without enema.
- Group B received 500 mg levofloxacin plus enema.
- Group C (control) received 3-day levofloxacin plus enema.
- Patients assessed for febrile urinary tract infection (FUTI) if symptoms developed within 2 weeks after biopsy.
- Funding: Ningbo Natural Science Fund; Zhejiang Natural Science Fund.
- 15 patients developed FUTI: 7 from group A (5%), 6 from group B (4.3%), and 2 from group C (1.4%).
- Among high-risk patients, FUTI incidence was significantly higher in group A than in group C (P=.015).
- Infection rates did not differ between groups A and B, whether patients were high- or low-risk.
- Single center, with a small sample size and few high-risk patients.
- All patients were from eastern China; results may not apply to other populations.