Editorial Comments on Antibiotic Prophylaxis for the Prevention of Infectious Complications following Prostate Biopsy: A Systematic Review and Meta-Analysis

Pilatz et al presented a systematic review and meta-analysis of different antibiotic prophylaxis regimens used to reduce risks of infectious complications after prostate biopsy.1 A regimen of 1 full day of prophylaxis appeared to be similar to 3 days of prophylaxis for the prevention of infectious complications. Fluoroquinolones could be replaced with other antimicrobial drugs as antimicrobial prophylaxis prior to prostate biopsy. An important limitation of the present study is that the types of infections complications are not reported. Distinguishing easily treatable infection that do not require hospitalization from cases of sepsis would be useful for better compression and interpretation of the results. This limitation is due to the available data and not the authors’ approach. Of note, rates of hospitalization, when available, were collected, analyzed and reported in the supplementary Appendixes. In terms of hospitalization rates, no differences were reported between men treated with short-term prophylaxis vs long-term prophylaxis, and between men who received antimicrobial prophylaxis based on nonfluoroquinolone antibiotics vs those who received fluoroquinolones. These considerations could reassure those who would still choose fluoroquinolones despite the European Commission recommendation. The field of infectious disease management is rapidly evolving. Misuse of antibiotics has led to the worrisome public health problem of antimicrobial resistance. Studies aimed at improving the use of antibiotic therapy would help preserve the lifesaving power of these drugs.2