The effects of antibiotics used prophylatic in prostate biopsy on the complications developing after biopsy

Aim: The aim of this study was to choose an appropiate prophylactic antibiotic which will prevent the post procedural complications in patients undergoing prostate biopsy by comparing the prophylactic efficacy of fosfomycin, amoxicillin+clavulanic acid and cefixim. Method: Data of patients with suspicion of prostate cancer and whom underwent transrectal prostate biopsy between September 2021 and July 2022, at Dicle University Urology Outpatient Clinic following the approval of local ethic commite (Date:12.12.2022, No:2) retrospectively reviewed. Patients were divided into three groups according to the antibiotics they used. First group ( Group 1, n:31) received fosfomycin as prophylactic antibiotic, second group (Group 2, n:34) received amoxicillin+ clavulanic acid, third group ( Group3, n:31) received cefixim. Patients were evaluated and compared in terms of post procedure hematuria, hematospermia, rectal bledding, fever, pain, laboratory values, IPSS scores and hospitalization. Results: 96 male patients were included in the study. When the patients were evaluated after the procedure, there was a statistically significant difference between the groups in terms of hospitalization and urine culture growth. The hospitalization and urine culture growth numbers in the cefixim and fosfomycinwas low and statictically significant. No statistically significant difference was observed between groups in terms of WBC, CRP change after the procedure. There was no statistically significant difference between fever, pain, hematuria, hematospermia, rectal bleeding and the mean scores of IPSS after the procedure. Conclusion: As its efficacy is low amoxicillin+clavulanic acid should not be used prophhlacsis in patients scheduled for prostate biopsy. With their high efficacy fosfomycin and cefixim appears as an atractive alternative prophylactic agents. With it's price and easy application fosfomycin has more advantages and shoul be preferred primarily. KeyWords: ProstateBiopsy, Fosfomycin, Cefixim, Amoxicilline+clavulanic acid, Prophylaxis