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Efficacy Study of Prophylaxis With Fosfomycin Versus Ciprofloxacin Prior Prostate Biopsy

Phase 4
Completed
Conditions
Urinary Tract Infections
Interventions
Registration Number
NCT01803191
Lead Sponsor
Fundacion para la Formacion e Investigacion Sanitarias de la Region de Murcia
Brief Summary

The purpose of this clinical trial is compare the incidence of symptomatic or asymptomatic bacteriuria after transrectal ultrasound guided prostate biopsy using a single dose of fosfomycin 3 g one hour before the biopsy compared to observed with the use of a single dose of ciprofloxacin 500 mg 1 hour before biopsy.

Detailed Description

Transrectal ultrasound guided (TRUS) prostate biopsy is the procedure of choice for the diagnosis of prostate cancer. This technique is usually safe and well tolerated with a low incidence of serious complications. However, one of these complications, the bacterial infection can be complicated and cause urinary sepsis. The investigators have developed different regimens of antibiotic prophylaxis. Most of them include administering oral fluoroquinolones. In this area, approximately 40% of the strains of E. coli are resistant to ciprofloxacin (fluoroquinolone). Therefore, research is warranted alternative prophylactic approaches. Fosfomycin is an antibiotic ancient underused in recent decades that in recent years has been proposed as an alternative treatment for infections caused by multidrug-resistant microorganisms.

Recruitment & Eligibility

Status
COMPLETED
Sex
Male
Target Recruitment
461
Inclusion Criteria
  • Age > 18 years
  • Patients with prostate-specific antigen (PSA) values >4 ng/ml or presenting either abnormality in rectal examination
  • Patients who accept to participate in the study signing the consent informed form
Exclusion Criteria
  • Allergy to anyone of the study drug
  • Intolerance to anyone of the study drug
  • Urinary infection with positive uroculture
  • Clinical finds suggesting infections
  • Antimicrobial treatment during the las 4 weeks
  • Patients with vesicle catheter
  • Patients in dialysis
  • Patients in hemodialysis

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Fosfomycin 3 gFosfomycin 3 gUnique oral dosis of 3 g of fosfomycin 1hour before of biopsy
Ciprofloxacin 500 mgCiprofloxacin 500 mgUnique oral dosis of ciprofloxacin 500 mg before biopsy
Primary Outcome Measures
NameTimeMethod
Bacteriuria28 days

Positive urine culture(\>10000 ufc/ml)

Secondary Outcome Measures
NameTimeMethod
Bacteremia28 days

Presence of bacteria in the blood (blood culture positive)

Urinary Tract Infection28 days

clinical symptoms (burning urination, urgent urination, urinary frequency)

Sepsis28 days

Systemic inflammatory response syndrome secondary to urinary tract infection

Pathogens present in urine and antimicrobial resistance28 days
Hematuria28 days

Blood in urine (Complication of transrectal ultrasound guided prostate)

Hemospermia28 days

Blood in the semen (Complication of transrectal ultrasound guided prostate)

Rectal bleeding28 days

Loss of red blood through the anus(Complication of transrectal ultrasound guided prostate)

Urinary retention28 days

Complication of transrectal ultrasound guided prostate

Difficulty for miction28 days

Complication of transrectal ultrasound guided prostate

Genitourinary infections associated to fever (>38ºC)28 days

Fever \>38ºC with some of this symptoms: dysuria, polyuria or suprapubic ache

Number of participants with adverse events28 days

Trial Locations

Locations (3)

Hospital Universitario Virgen de la Arrixaca

🇪🇸

El Palmar, Murcia, Spain

Hospital General Universitario Santa Lucía

🇪🇸

Cartagena, Murcia, Spain

Hospital General Universitario Los Arcos del Mar Menor

🇪🇸

San Javier, Murcia, Spain

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