Correction: Infection risk reduction with povidone-iodine rectal disinfection prior to transrectal prostate biopsy: an updated systematic review and meta-analysis - Scorecard - MDSpire

Correction: Infection risk reduction with povidone-iodine rectal disinfection prior to transrectal prostate biopsy: an updated systematic review and meta-analysis

  • By

  • Ichiro Tsuboi

  • Akihiro Matsukawa

  • Mehdi Kardoust Parizi

  • Jakob Klemm

  • Stefano Mancon

  • Sever Chiujdea

  • Tamás Fazekas

  • Ekaterina Laukhtina

  • Tatsushi Kawada

  • Satoshi Katayama

  • Takehiro Iwata

  • Kensuke Bekku

  • Koichiro Wada

  • Motoo Araki

  • Shahrokh F. Shariat

  • September 14, 2024

  • 0 min

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Clinical Scorecard: Updated Systematic Review and Meta-Analysis on the Efficacy of Povidone-Iodine Rectal Disinfection in Reducing Infection Risk Before Transrectal Prostate Biopsy

At a Glance

CategoryDetail
ConditionInfectious complications following transrectal ultrasound-guided prostate biopsy (TRUS-PB)
Key MechanismsRectal disinfection with povidone-iodine (PI) reduces bacterial translocation and infection risk during TRUS-PB
Target PopulationPatients undergoing transrectal ultrasound-guided prostate biopsy
Care SettingUrology outpatient or hospital settings performing prostate biopsy

Key Highlights

  • Rectal disinfection with povidone-iodine significantly lowers overall infectious complications and fever rates after TRUS-PB.
  • Combination of antibiotic prophylaxis (AP) and PI is more effective than AP alone in reducing infections and fever.
  • PI disinfection does not significantly reduce the incidence of sepsis following TRUS-PB.

Guideline-Based Recommendations

Diagnosis

  • Use transrectal ultrasound-guided prostate biopsy (TRUS-PB) for prostate cancer diagnosis where indicated.

Management

  • Perform rectal disinfection with povidone-iodine prior to TRUS-PB to reduce infectious complications.
  • Administer antibiotic prophylaxis in combination with PI disinfection for optimal infection risk reduction.

Monitoring & Follow-up

  • Monitor patients post-TRUS-PB for signs of infection including fever and sepsis.

Risks

  • Infectious complications including acute bacterial prostatitis, fever, and sepsis can occur post-TRUS-PB.
  • PI disinfection reduces infection risk but does not significantly impact sepsis rates.

Patient & Prescribing Data

Patients undergoing TRUS-PB with or without prior antibiotic prophylaxis

Use of fluoroquinolone antibiotics combined with PI disinfection is associated with lower infection and fever rates compared to non-fluoroquinolone antibiotics.

Clinical Best Practices

  • Incorporate rectal disinfection with povidone-iodine as a standard pre-procedural step before TRUS-PB.
  • Combine antibiotic prophylaxis with PI disinfection to maximize reduction in infectious complications.
  • Consider fluoroquinolone antibiotics preferentially when selecting prophylactic antibiotics for TRUS-PB.
  • Remain vigilant for infectious complications post-biopsy despite prophylactic measures.

References

Original Source(s)

Correction: Infection risk reduction with povidone-iodine rectal disinfection prior to transrectal prostate biopsy: an updated systematic review and meta-analysis

  • by Ichiro Tsuboi, Akihiro Matsukawa, Mehdi Kardoust Parizi, Jakob Klemm, Stefano Mancon, Sever Chiujdea, Tamás Fazekas, Ekaterina Laukhtina, Tatsushi Kawada, Satoshi Katayama, Takehiro Iwata, Kensuke Bekku, Koichiro Wada, Motoo Araki, Shahrokh F. Shariat

  • September 14, 2024

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