The clinical landscape of prostate biopsy (PB) is evolving with changes in procedures and techniques. Moreover, antibiotic resistance is increasing and influences the efficacy of pre-biopsy prophylactic regimens. Therefore, increasing antibiotic resistance may impact on clinical care, which probably results in differences between hospitals. The objective of our study is to determine the (variability in) current practices of PB in the Netherlands and to gain insight into Dutch urologists’ perceptions of fluoroquinolone resistance and biopsy related infections. An online questionnaire was prepared using SurveyMonkey® platform and distributed to all 420 members of the Dutch Association of Urology, who work in 81 Dutch hospitals. Information about PB techniques and periprocedural antimicrobial prophylaxis was collected. Urologists’ perceptions regarding pre-biopsy antibiotic prophylaxis in an era of antibiotic resistance was assessed. Descriptive statistical analysis was performed. One hundred sixty-one responses (38.3%) were analyzed representing 65 (80.3%) of all Dutch hospitals performing PB. Transrectal ultrasound guided prostate biopsy (TRUSPB) was performed in 64 (98.5%) hospitals. 43.1% of the hospitals (also) used other image-guided biopsy techniques. Twenty-three different empirical prophylactic regimens were reported among the hospitals. Ciprofloxacin was most commonly prescribed (84.4%). The duration ranged from one pre-biopsy dose (59.4%) to 5 days extended prophylaxis. 25.2% of the urologists experienced ciprofloxacin resistance as a current problem in the prevention of biopsy related infections and 73.6% as a future problem. There is a wide variation in practice patterns among Dutch urologists. TRUSPB is the most commonly used biopsy technique, but other image-guided biopsy techniques are increasingly used. Antimicrobial prophylaxis is not standardized and prolonged prophylaxis is common. The wide variation in practice patterns and lack of standardization underlines the need for evidence-based recommendations to guide urologists in choosing appropriate antimicrobial prophylaxis for PB in the context of increasing antibiotic resistance.

中文翻译：

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前列腺活检技术和活检前预防措施：荷兰当前实践模式的变化


前列腺活检 (PB) 的临床前景随着程序和技术的变化而不断发展。此外，抗生素耐药性正在增加，并影响活检前预防方案的功效。因此，抗生素耐药性的增加可能会影响临床护理，这可能会导致医院之间存在差异。我们研究的目的是确定荷兰当前 PB 实践的（变异性），并深入了解荷兰泌尿科医师对氟喹诺酮耐药性和活检相关感染的看法。使用 SurveyMonkey® 平台准备了一份在线调查问卷，并将其分发给在 81 家荷兰医院工作的荷兰泌尿外科协会的所有 420 名成员。收集有关 PB 技术和围手术期抗菌预防的信息。评估了泌尿科医生在抗生素耐药性时代对活检前抗生素预防的看法。进行了描述性统计分析。对 161 份答复 (38.3%) 进行了分析，代表了荷兰所有执行 PB 的医院中的 65 家 (80.3%)。 64 家 (98.5%) 医院进行了经直肠超声引导前列腺活检 (TRUSPB)。 43.1% 的医院还使用其他图像引导活检技术。医院报告了二十三种不同的经验性预防方案。环丙沙星是最常用的处方（84.4%）。持续时间范围从活检前一剂 (59.4%) 到 5 天延长预防。 25.2% 的泌尿科医生认为环丙沙星耐药性是预防活检相关感染的当前问题，73.6% 的泌尿科医生认为环丙沙星耐药性是未来的问题。荷兰泌尿科医生的实践模式存在很大差异。 TRUSPB 是最常用的活检技术，但其他图像引导活检技术的使用也越来越多。抗菌药物预防尚未标准化，长期预防也很常见。实践模式的巨大差异和标准化的缺乏强调需要基于证据的建议来指导泌尿科医师在抗生素耐药性增加的背景下选择适当的抗菌药物预防 PB。