{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T22:15:41Z","timestamp":1790806541344,"version":"4.1.0"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2022,11,24]],"date-time":"2022-11-24T00:00:00Z","timestamp":1669248000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001826","name":"The Netherlands Organisation for Health Research and Development","doi-asserted-by":"crossref","award":["541001009"],"award-info":[{"award-number":["541001009"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,4,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>An increase in infections after transrectal prostate biopsy (PB), related to an increasing number of patients with ciprofloxacin-resistant rectal flora, necessitates the exploration of alternatives for the traditionally used empirical prophylaxis of ciprofloxacin. We compared infectious complication rates after transrectal PB using empirical ciprofloxacin prophylaxis versus culture-based prophylaxis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this nonblinded, randomized trial, between 4 April 2018 and 30 July 2021, we enrolled 1538 patients from 11 Dutch hospitals undergoing transrectal PB. After rectal swab collection, patients were randomized 1:1 to receive empirical prophylaxis with oral ciprofloxacin (control group [CG]) or culture-based prophylaxis (intervention group [IG]). Primary outcome was any infectious complication within 7 days after biopsy. Secondary outcomes were infectious complications within 30 days, and bacteremia and bacteriuria within 7 and 30 days postbiopsy. For primary outcome analysis, the \u03c72 test stratified for hospitals was used. Trial registration number: NCT03228108.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Data from 1288 patients (83.7%) were available for analysis (CG, 652; IG, 636). Infection rates within 7 days postbiopsy were 4.3% (n = 28) (CG) and 2.5% (n = 16) (IG) (P value = .08; reduction: \u22121.8%; 95% confidence interval, \u2212.004 to .040). Ciprofloxacin-resistant bacteria were detected in 15.2% (n = 1288). In the CG, the presence of ciprofloxacin-resistant rectal flora resulted in a 6.2-fold higher risk of early postbiopsy infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our study supports the use of culture-based prophylaxis to reduce infectious complications after transrectal PB. Despite adequate prophylaxis, postbiopsy infections can still occur. Therefore, culture-based prophylaxis must be weighed against other strategies that could reduce postbiopsy infections.<\/jats:p>\n                    <jats:p>Clinical Trials Registration. NCT03228108.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciac913","type":"journal-article","created":{"date-parts":[[2022,11,24]],"date-time":"2022-11-24T01:19:25Z","timestamp":1669252765000},"page":"1188-1196","source":"Crossref","is-referenced-by-count":29,"title":["Rectal Culture-Based Versus Empirical Antibiotic Prophylaxis to Prevent Infectious Complications in Men Undergoing Transrectal Prostate Biopsy: A Randomized, Nonblinded Multicenter Trial"],"prefix":"10.1093","volume":"76","author":[{"given":"Sofie C M","family":"Tops","sequence":"first","affiliation":[{"name":"Department of Medical Microbiology and Radboudumc Center for Infectious Diseases, Radboud University Medical Center , Nijmegen , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Kolwijck","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Jeroen Bosch Hospital , \u2018s-Hertogenbosch , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evert L","family":"Koldewijn","sequence":"additional","affiliation":[{"name":"Department of Urology, Catharina Hospital , Eindhoven , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diederik M","family":"Somford","sequence":"additional","affiliation":[{"name":"Department of Urology, Canisius Wilhelmina Hospital , Nijmegen , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filip J M","family":"Delaere","sequence":"additional","affiliation":[{"name":"Department of Urology, Zuyderland , Heerlen , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Menno A","family":"van Leeuwen","sequence":"additional","affiliation":[{"name":"Department of Urology, Bravis , Roosendaal , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthonius J","family":"Breeuwsma","sequence":"additional","affiliation":[{"name":"ETZ hospital , Tilburg , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thijn F","family":"de Vocht","sequence":"additional","affiliation":[{"name":"Department of Urology, Bernhoven , Uden , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans J H P","family":"Broos","sequence":"additional","affiliation":[{"name":"Department of Urology, Amphia , Breda , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rob A","family":"Schipper","sequence":"additional","affiliation":[{"name":"Department of Urology, Jeroen Bosch Hospital , \u2018s-Hertogenbosch , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martijn G","family":"Steffens","sequence":"additional","affiliation":[{"name":"Department of Urology, Isala , Zwolle , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Teerenstra","sequence":"additional","affiliation":[{"name":"Department for Health Evidence, Section Biostatistics, Radboud University Medical Center , Nijmegen , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marjolijn C A","family":"Wegdam-Blans","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, University Medical Center Utrecht, Utrecht University , Utrecht , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Els","family":"de Brauwer","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Zuyderland , Heerlen , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wouter","family":"van den Bijllaardt","sequence":"additional","affiliation":[{"name":"Microvida Laboratory for Medical Microbiology, Amphia Hospital , Breda , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander C A P","family":"Leenders","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Jeroen Bosch Hospital , \u2018s-Hertogenbosch , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J P Michiel","family":"Sedelaar","sequence":"additional","affiliation":[{"name":"Department of Urology, Radboud University Medical Center , Nijmegen , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heiman F L","family":"Wertheim","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Radboudumc Center for Infectious Diseases, Radboud University Medical Center , Nijmegen , The 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