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Infection most common cause for 30-day hospitalization after prostate biopsy
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Infection was the most common cause of hospitalization among men who had undergone a prostate biopsy within the last 30 days, study data showed.
“The incidence of infectious complications following prostate biopsy has been rising over the past two decades, with estimates of this increase ranging from 100% to 300%,” Infectious Disease News Board Member Keith Kaye, MD, MPH, professor of internal medicine at the University of Michigan Medical School, and colleagues wrote.
Researchers noted that the American Urological Association recommends fluoroquinolones as prophylaxis.
“Screening men for colonization with fluoroquinolone-resistant organisms prior to initiation of prophylactic antibiotics has been proposed as a strategy to reduce the incidence of post-biopsy infection. The development and implementation of such programs are resource intensive, and require an understanding of the overall risk of post-biopsy complications and costs,” the researchers said.
Kaye and colleagues performed a retrospective cohort study on a national sample of men aged 40 years and older (n = 55,700) using patient data from Medicare and Tuven Health Analytics MarketScan Commercial Claims and Encounters databases, analyzing a total of 515,045 prostate biopsies performed from 2005 to 2012 and identifying signs of infection, as well as treatment with antibiotics.
Median patient age was 62 years. The 30-day hospitalization rate was 3.1% (n = 15,977), Kaye and colleagues reported, and half of those patients (1.55%; n = 7,984) had been admitted for infection management. The median length of hospital stay was 3 days, and the mean payment for hospitalization was $15,238.71. Among patients admitted for infections, the mean cost of hospitalization was $14,498.96, the researchers wrote. More than two-thirds (67.4%) of infections were septic conditions. Forty-five patients from the total cohort died in the hospital, Kaye and colleagues reported, and 71% of those who died (n = 32) had a documented infection. Infectious post-biopsy complications had a mean cost of $14 million per year. Data on prophylactic antibiotics were available for just 16.4% of biopsies, according to the researchers. Fluoroquinolones were the most commonly prescribed prophylactic antibiotics.
“Despite widespread use of fluoroquinolone antibiotic prophylaxis for prevention of infection following prostate biopsy, infection was the most common reason for 30-day hospital readmission,” the researchers wrote. “This may be due, at least in part, to the emergence of multi-drug resistance pathogens. Continued efforts are needed to optimize prophylaxis strategies and best practice guidelines to prevent these complications and reduce patient cost and hospital utilization.” – by Andy Polhamus
Disclosure: The researchers report no relevant financial disclosures.
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