Antibiotic prophylaxis in prostate biopsy: a comparative randomized clinical assay between ciprofloxacin, norfloxacin and chloramphenicol

ABSTRACT

OBJECTIVE: To compare, prospectively, 4 different schemes of antibiotic prophylaxis previously to transrectal prostate biopsy. MATERIALS AND METHODS: 257 patients were randomized in 4 groups: Group I: single dose of ciprofloxacin 2 hours before the procedure; Group II: ciprofloxacin 3 days; Group III: chloramphenicol 3 days; and Group IV: norfloxacin 3 days. The complication rate was assessed in a blind way on the third and on the thirtieth days through a questionnaire. Groups were compared by the qui-square method and, in small samples, by the Fisher method, with statistical significance of 95 percent. RESULTS: Complications index throughout the sample differed between the 4 groups of patients under study, being 3.1 percent for group I, 2.1 percent for group II, 18.3 percent for group III and 10.5 percent for group IV. Schemes employing ciprofloxacin were statistically superior to those that used norfloxacin or chloramphenicol (p < 0.05). There was no difference between a single dose and 3 days of ciprofloxacin (p > 0.05). CONCLUSION: Schemes using ciprofloxacin presented better results in prophylaxis previously to prostate biopsy. We recommend using a single dose of ciprofloxacin due to its posologic ease and low cost, associated with a therapeutic response equivalent to 3-day regimens.