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Topical rectal antiseptic at time of prostate biopsy: how a resident patient safety project has evolved into institutional practice
- Source :
- International urology and nephrology. 50(9)
- Publication Year :
- 2018
-
Abstract
- To report outcomes 5 years after a resident quality initiative incorporated topical rectal antiseptic into our ultrasound-guided prostate needle biopsy (TRUS PNB) protocol. A chart review was conducted on 1007 men who underwent TRUS PNB between 2010 and 2017. Comparison groups include those who received a topical rectal antiseptic (N = 437) compared to those who did not (N = 570). Povidone-iodine (N = 303) or 4% chlorhexidine solution without alcohol (N = 134) were topical agents. Outcomes of interest included post-biopsy infection (urinary tract infection and/or sepsis), hospital admission, and need for ICU monitoring. Median age and PSA of men included in this study were 64 years and 12 ng/mL. Almost 90% of patients were Caucasian, 13% had diabetes, 3% were on immunosuppression, 32% had at least one prior biopsy, 14% received antibiotics, and 7% were hospitalized in the past 6 months. 22 patients (2.2%) developed a post-biopsy infection with a significant reduction in the group receiving topical rectal antiseptic (0.8 vs. 3.3%, p = 0.01). Post-biopsy UTI rates (p = 0.04) and hospital admission (p = 0.03) were also lower in the topical antiseptic group with trends to reduction in sepsis and need for ICU monitoring. What started as a resident quality safety project 5 years ago has demonstrated a reduction in infections and hospital admissions following TRUS PNB. Our institutional practice now routinely uses povidone-iodine or chlorhexidine as an adjunct to oral quinolones for TRUS PNB perioperative prophylaxis.
- Subjects :
- Nephrology
Image-Guided Biopsy
Male
medicine.medical_specialty
Prostate biopsy
Critical Care
medicine.drug_class
Urology
Urinary system
Administration, Topical
030232 urology & nephrology
Antisepsis
Sepsis
03 medical and health sciences
0302 clinical medicine
Antiseptic
Internal medicine
Biopsy
medicine
Humans
Povidone-Iodine
Aged
medicine.diagnostic_test
business.industry
Chlorhexidine
Prostate
Perioperative
Middle Aged
medicine.disease
Quality Improvement
Hospitalization
030220 oncology & carcinogenesis
Urinary Tract Infections
Anti-Infective Agents, Local
Patient Safety
business
medicine.drug
Subjects
Details
- ISSN :
- 15732584
- Volume :
- 50
- Issue :
- 9
- Database :
- OpenAIRE
- Journal :
- International urology and nephrology
- Accession number :
- edsair.doi.dedup.....8e2caa8c4bed44e1c379609bae6f1239