Diagnosing prostate cancer is done by means of a prostate biopsy, in which small pieces of tissue are taken from the prostate. During such a biopsy, the doctor in most cases punctures the prostate via the intestine. Intestinal bacteria can cause an infection of the prostate or urinary tract. To prevent an infection, patients are preventively given the antibiotic ciprofloxacin. But this drug does not work in all patients, because intestinal bacteria have become increasingly insensitive to it. The result is more infections after prostate biopsy, putting patients at risk for serious disease. This can lead to blood poisoning, hospitalization and, in rare cases, death.
Researchers at Radboudumc therefore wanted to find out whether it would be better to prescribe tailor-made antibiotics for patients whose intestinal bacteria are resistant to the usual treatment. This turned out to be the case, says research physician Sofie Tops: “One group of patients received the standard treatment with ciprofloxacin. In the other group, we investigated who had gut bacteria that are insensitive to this drug. Those patients received tailor-made antibiotics. In this second group we saw 2.5 percent infections within seven days after the biopsy, in the standard treatment group 4.3 percent.”
Six times greater risk of infection
When the researchers only looked at the group that received the standard antibiotic, a clear difference emerged. There, 14.7 percent of the men with insensitive gut bacteria developed an infection, versus 2.4 percent of the men with sensitive gut bacteria. This means that patients with refractory gut bacteria who received the standard antibiotic were six times more likely to develop an infection after prostate biopsy than patients with sensitive gut bacteria. A big difference, Tops agrees. “This shows that tailored antibiotics can contribute to fewer infections after prostate biopsy.”
Nevertheless, some of the patients who used a tailor-made antibiotic still developed an infection. Tops and her colleagues suspect that this is due to the amount of intestinal bacteria. “We want to investigate this further. There is also another way to reduce the risk of infection. It has been proven effective to disinfect the intestine with iodine prior to the study. We do not do that enough. If we combine this with tailor-made antibiotics may reduce the risk even further. This is important not only in the Netherlands, but also in the rest of the world, where antibiotic resistance is a major problem in some parts.”
By: National Care Guide