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Transrectal Ultrasound (TRUS)-Guided Prostate Biopsy
Published in Ayman El-Baz, Gyan Pareek, Jasjit S. Suri, Prostate Cancer Imaging, 2018
Jennifer Fantasia, Dragan Golijanin, Boris Gershman
Infectious complications have received growing attention in recent years given increasing risk of serious infectious complications following prostate biopsy (Loeb et al. 2011). Peri-procedural antibiotic prophylaxis mitigates this risk. Identified risk factors include healthcare workers, prior antibiotic exposure within 6 months, and recent international travel to areas with high rates of resistance (Anderson et al. 2015). AUA guidelines recommend that all patients undergoing prostate biopsy receive antibiotic prophylaxis against coliform, or intestinal, bacteria including E. coli, klebsiella, proteus, enterobacter, serrattia, enterococcus, and anaerobes (Wolf et al. 2008). However, since the clinical introduction of prostate biopsy, antimicrobial resistance patterns have significantly increased, correlating with a 4% increase in the risk of hospitalization, largely due to the infectious complications of TRUS prostate biopsy in the setting of antibiotic-resistant bacteria (Nam et al. 2010). Currently, the AUA guidelines published in 2014 still recommend either fluoroquinolone-based or first-, second-, or third-generation cephalosporin antibiotic prophylaxis as a first-line therapy, for a duration of <24 hours. Alternative prophylactic regimens include Bactrim and aminoglycosides or aztreonam.
Pulmonary complications of bone-marrow and stem-cell transplantation
Published in Philippe Camus, Edward C Rosenow, Drug-induced and Iatrogenic Respiratory Disease, 2010
Bekele Afessa, Andrew D Badley, Steve G Peters
The aetiology of bacterial infection in neutropenic patients is in flux.86 Gram-negative bacteria, especially Pseudomonas aeruginosa, used to be the most common pathogens causing pneumonia.87 However, owing to the use of prophylactic antibiotics to prevent Gram-negative infection, and the use of intravascular catheters, Gram-positive organisms are becoming more frequent. Patients who have received minimal or no prophylaxis develop infection predominantly with Gram-negative organisms, whereas those with antibiotic prophylaxis develop infection with Gram-positive bacteria. The use of narcotics for pain associated with mucositis increases the risk of aspiration pneumonia.
Gastrointestinal tract and salivary glands
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
Patients undergoing upper GI endoscopic sonography are starved for 4 hours prior to the procedure, which is performed under light sedation and takes 15–60 minutes depending on the interventions performed. Drainage of cysts requires antibiotic prophylaxis. Transrectal EUS requires phosphate enema to clear the rectum and sigmoid colon, and rarely requires sedation. Patients usually go home after resting in the department for an hour or two.
Prevention and management of endocarditis after transcatheter pulmonary valve replacement: current status and future prospects
Published in Expert Review of Medical Devices, 2021
Specific prophylactic therapies may also play a role in reducing the risk of endocarditis after TPVR. Patients with a transcatheter valve prosthesis meet the American Heart Association and American College of Cardiology criteria for antibiotic prophylaxis prior to dental procedures [63], and it is standard to follow these guidelines after TPVR. In addition, it has been common practice to prescribe low-dose aspirin after TPVR in an effort to prevent thrombus formation, and it has been proposed that discontinuation of aspirin may be an inciting factor for endocarditis. Although animal models support the benefit of anticoagulant/antiplatelet therapy for reduction of endocarditis risk in the context of bacteremia [64,65], there is no evidence that low-dose aspirin alone is beneficial in this regard in humans, or even effective at preventing formation of thrombus in general or within the TPV-conduit complex in particular. Nevertheless, given the mechanistic rationale and relative lack of side effects or morbidity, and pending compelling evidence that low-dose aspirin is or is not effective for this purpose, it seems reasonable to recommend indefinite empirical prophylaxis.