THE EFFECT OF POVIDONE IODINE INTRARECTAL TO REDUCE BACTERIURIA, BACTEREMIA, AND SIRS AFTER TRUS PROSTATE BIOPSY
Abstract: To compare the
incidence of bacteruria, bacteremia, and Systemic Inflammatory Response
Syndrome (SIRS) after Transrectal Ultrasound (TRUS) of prostate biopsy for the
patients whom given intrarectal povidone iodine, enema, prophylactic antibiotic
with given enema and prophylactic antibiotic. Material & Methods: A
Randomised, experimental study, 20 samples of men with suspicious of prostate
cancer were divided into two groups, first group (control) were given enema
(dulcolax supp 10 mg) and prophylactic antibiotic (ciprofloxacin 1000 mg),
second group (treatment) were given enema (dulcolax supp 10 mg) prophylactic
antibiotic (ciprofloxacin 1000 mg), and intrarectal povidone iodine befotre
TRUS of prostate biopsy. Urine and rectal swab culture examination were
performed before biopsy then urine, blood culture, and blood leucocyte 2 days
after biopsy. To assess any bacterial translocation from rectum to urinary
tract, we match the post biopsy urine culture antibiogram and rectal swab
culture antibiogram before biopsy. Complications and serious adverse effects
were also monitored. Outcomes were assessed using Unpaired T Test and Mann
Whitney depends on the data distribution and homogeneity. Results: There was no
significant difference bacteriuria between groups (p=0.26). Bacteremia and SIRS
were not found within two groups 2 days after prostate biopsy. Post biopsy bacteriuria positive patients
antibiogram were compared with pre biopsy swab rectal culture antibiogram,
there was no significant difference between two groups. But, significant
correlation of pre biopsy rectal swab culture with post biopsy urine culture
(p=0.04) were noted. Conclusion: Intrarectal povidone iodine before TRUS of
prostate biopsy were not needed as part of rectal preparation, since enema and
prophylactic antibiotic was proven to decrease the incidence of bacteriuria,
bacteremia, and SIRS after TRUS of prostate biopsy. The occurrance of
bacteriuria were caused by bacterial translocation from rectum to urinary
tract.
Keywords: Prostate biopsy;
Povidone iodine; prophylactic antibiotic; Enema; Bacteriuria; Bacteremia;
systemic inflammatory response syndrome
Author: Rifky Aulia, Fikri
Rizaldi, Sunaryo Hardjowijoto
Journal Code: jpkedokterangg180011
