human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To compare , prospect ively , 4 different schemes of antibiotic prophylaxis previously to transrectal prostate biopsy . MATERIAL S AND METHODS 257 patients were r and omized in 4 groups : Group I : single dose of ciprofloxacin 2 hours before the procedure ; Group II : ciprofloxacin 3 days ; Group III : chloramphenicol 3 days ; and Group IV : norfloxacin 3 days . The complication rate was assessed in a blind way on the third and on the thirtieth days through a question naire . Groups were compared by the qui-square method and , in small sample s , by the Fisher method , with statistical significance of 95 % . RESULTS Complications index throughout the sample differed between the 4 groups of patients under study , being 3.1 % for group I , 2.1%for group II , 18.3 % for group III and 10.5 % for group IV . Schemes employing ciprofloxacin were statistically superior to those that used norfloxacin or chloramphenicol ( p < 0.05 ) . There was no difference between a single dose and 3 days of ciprofloxacin ( p > 0.05 ) . CONCLUSION Schemes using ciprofloxacin presented better results in prophylaxis previously to prostate biopsy . We recommend using a single dose of ciprofloxacin due to its posologic ease and low cost , associated with a therapeutic response equivalent to 3-day regimens Purpose To compare the antibiotic prophylaxis based on quinolone administered orally with a combination of cephalosporin administered periprostatically and a fluoroquinolone orally , in terms of post-prostate bioptic infectious complication rates in those men undergoing transrectal ultrasound-guided prostate biopsy ( TRUS gpb ) . Methods In a prospect i ve , r and omized , double-blind study , 150 consecutive patients were r and omized to receive 10 ml lidocaine 1 % in Group A and ceftriaxone 1 g diluted in a solution of 10 ml of lidocaine 1 % in Group B , before TRUS gpb . All signed the informed consent . The men were asked to grade the pain using a ten points visual analogue scale close after TRUS gpb . In a telephone interview at 3 and 6 days , they were asked about early and late complications , assessing rectal bleeding , urinary retection , fewer , haematuria , urethral bleeding and hematospermia . Results Of the 150 men enrolled , 135 , 70 in Groups A and 65 in Group B , completed the study . Four men ( 5.7 % ) in Group A developed sepsis after TRUS gpb requiring hospital admission and intravenous antibiotic treatment , while none in Group B. Escherichia coli was the only organism isolated . The mean pain score was 2.76 ± 1.69 and 1.73 ± 1.26 for Group A and B , respectively ( p = 0.08 ) . Complications , evaluated at 3 and 6 days after the procedure through a telephone interview , were similar in both Groups . Conclusions The antibiotic prophylaxis based on the combination of ceftriaxone administered periprostatically and ciprofloxacin orally is able to offer a best control on infections caused by fluoroquinolone-resistant E. coli Transrectal biopsy is one of the more popular methods for the diagnosis of prostatic cancer . However , there is disagreement as to whether the use of prophylactic antimicrobials decreases the incidence of fever and urinary tract infections , which may follow this procedure . A prospect i ve r and omized double-blind study involving 63 patients was instituted to determine the efficacy of carbenicillin indanyl sodium in reducing these complications . The protocol consisted of administration of 2 tablets of 4 times daily of a placebo or the treatment drug 24 hours before and after biopsy . Clean catch urine cultures were obtained 24 hours before biopsy and at 48 hours and 2 weeks after the procedure . Blood cultures were performed 15 minutes after biopsy . In addition , clinical parameters were monitored closely in the hospital for 48 hours after biopsy . A total of 48 patients was considered evaluable . Of 23 patients who received the study drug 2 ( 8.6 per cent ) had positive urine cultures at 48 hours compared to 9 of 25 ( 36 per cent ) from the placebo group . A similar result was observed from the 2-week culture data , in which 2 of 23 patients ( 8.6 per cent ) in the treatment group had positive urine cultures as opposed to 5 of 25 ( 20 per cent ) receiving the placebo .  Fever occurred in 48 per cent of the placebo and in 17 per cent of the carbenicillin groups . Our data indicate that prophylactic administration of carbenicillin indanyl sodium decreases the complications of fever and urinary tract infections following transrectal biopsy of the prostate BACKGROUND Infection is a serious adverse effect of  prostate biopsy ( P-Bx ) , and recent reports suggest an increasing incidence . OBJECTIVE The aim of this multinational multicentre study was to evaluate prospect ively the incidence of infective complications after P-Bx and identify risk factors . DESIGN , SETTING , AND PARTICIPANTS The study was performed as an adjunct to the Global Prevalence Study of Infections in Urology ( GPIU ) during 2010 and 2011 . Men undergoing P-Bx in participating centres during the 2-wk period commencing on the GPIU study census day were eligible . OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Baseline data were collected and men were question ed regarding infective complications at 2 wk following their biopsy . The Fisher exact test , Student t test , Mann-Whitney U test , and multivariate regression analysis were used for data analysis . RESULTS AND LIMITATIONS A total of 702 men from 84 GPIU participating centres worldwide were included . Antibiotic prophylaxis was administered prior to biopsy in 98.2 % of men predominantly using a fluoroquinolone ( 92.5 % ) . Outcome data were available for 521 men ( 74 % ) . Symptomatic urinary tract infection ( UTI ) was seen in 27 men ( 5.2 % ) , which was febrile in 18 ( 3.5 % ) and required hospitalisation in 16 ( 3.1 % ) . Multivariate analysis did not identify any patient subgroups at a significantly higher risk of infection after P-Bx . Causative organisms were isolated in 10 cases ( 37 % ) with 6 resistant to fluoroquinolones . The small sample size per participating site and in compared with other studies may have limited the conclusions from our study . CONCLUSIONS Infective complications after transrectal P-Bx are important because of the associated patient morbidity . Despite antibiotic prophylaxis , 5 % of men will experience an infective complication , but none of the possible factors we examined appeared to increase this risk . Our study confirms a high incidence of fluoroquinolone resistance in causative bacteria OBJECTIVE Prostate biopsy is a frequent diagnostic measure to detect prostatic conditions , including primarily prostate cancer . Its performance does not follow a pattern , mainly regarding preparation for the examination through antimicrobial prophylaxis . The aim of this study is to compare the efficiency of short and long term antimicrobial prophylaxis in transrectal ultrasound-guided prostate biopsies . MATERIAL S AND METHODS A clinical study was conducted with a total of 140 patients su bmi tted to prostate biopsy with transrectal ultrasonographic control . Patients were r and omly separated in two groups : Group 1 receiving norfloxacin 400 mg single dose before the procedure and Group 2 receiving norfloxacin 400 mg initiating before the procedure and then bid up to 6 doses . Efficiency control was determined by the incidence of urinary tract infection ( UTI ) and complications in both groups after statistical analysis . RESULTS The incidence of minor complications in our study was 75 % , consistent with data found in the literature . Among the patients with diagnosis of simple UTI , 23 % belonged to Group 1 and 8 % to Group 2 ( p=0.08 ) . Among the patients with complicated UTI , 37 % belonged to Group 1 and none belonged to Group 2 ( p=0.44 ) . CONCLUSIONS Several advances made transrectal ultrasound-guided prostate biopsies a useful and safe diagnostic tool in the workup of urologic patients . There is no optimal prophylactic preparation to the performance of this procedure . Long term antimicrobial prophylaxis presents a trend toward lower incidence of infectious complications Background Transrectal ultrasound-guided prostate biopsies ( TRUSBx ) , in spite of being one of the most frequently performed urological office procedures , are associated with a spectrum of complications , most significantly including infection . The aim of the study is to evaluate the prevalence of fluoroquinolone-resistant bacteria in rectal swabs from our local population prior to TRUSBx and to identify risk factors among a patient population harboring fluoroquinolone-resistant organisms . Methods We prospect ively included 541 men who were su bmi tted for TRUSBx in our center from March 2011 to June 2015 . The indications for TRUSBx were an elevated prostate-specific antigen level and /or abnormal digital rectal exam . All patients were r and omly divided into two groups : Group 1 ( n = 279 cases ) who received st and ard empirical prophylactic antibiotics and Group 2 who received targeted prophylaxis based on a rectal swab culture and susceptibility result . Differences in risk factors between quinolone-resistant and nonresistant patients were compared . Univariate and multivariate analyses were performed to identify independent potential risk factors associated with fluoroquinolone-resistant rectal flora . Results Sixteen out of 271 men developed infectious complications after TRUSBx in the group receiving st and ard empirical prophylaxis ( 5.7 % ) . No men in the group who received targeted prophylactic antibiotic guided by rectal swab developed infectious complications . Among the 262 patients who underwent prebiopsy rectal swab cultures , 76 men ( 29 % ) displayed fluoroquinolone-resistant rectal flora ( 29 % ) . In the multivariate analysis , a history of antibiotic exposure before prostate biopsy was the only independent factor associated with an increased risk of fluoroquinolone resistance . Conclusion Determining the prevalence of fluoroquinolone resistance in rectal flora has important implication s in the selection of targeted prophylactic antibiotic regimens . Antimicrobial profiles guided by rectal swabs may prove useful to optimize prophylaxis prior to TRUSBx ; this strategy is effective at reducing the rates of infectious complications , including sepsis , especially in men at higher risk of infectious complications PURPOSE Prostate biopsy related infectious complications are associated with significant morbidity . The risk of infectious complications in patients with prostate cancer on active surveillance remains under studied . MATERIAL S AND METHODS A total of 591 consecutive men who underwent prostate biopsy were prospect ively enrolled in a study evaluating prostate biopsy related complications between January 2011 and January 2012 . Of these men 403 were previously diagnosed with prostate cancer and were included in this study . They underwent a 14-core transrectal ultrasound guided prostate biopsy as part of an active surveillance regimen . A nurse contacted all men within 14 days of biopsy , and information was collected on potential complications , antibiotics received and bacterial culture results . RESULTS Fourteen patients ( 3.5 % ) had infectious complications including 13 requiring hospitalization . Five patients had positive urine cultures , and fluoroquinolone resistant isolates were identified in 4 patients , including 2 with extended spectrum beta-lactamase producing isolates . We evaluated the impact of risk factors including diabetes , benign prostatic hyperplasia and antibiotic regimen . However , only the number of previous prostate biopsies was significantly associated with an increased risk of infectious complications ( p = 0.041 ) . For every previous biopsy the odds of an infection increased 1.3 times ( OR 1.33 , 95 % CI 1.01 - 1.74 ) . CONCLUSIONS In men with prostate cancer on active surveillance the number of previous prostate biopsies is associated with a significant risk of infectious complications and every previous biopsy increases the risk of infectious complication . Fluoroquinolone resistant and extended spectrum beta-lactamase producing isolates represent the most commonly identified organisms . Men with prostate cancer on active surveillance should be informed of the risks associated with serial repeat prostate biopsies PURPOSE More than 1 million prostate biopsies are performed annually among Medicare beneficiaries . We determined the risk of serious complications requiring hospitalization . We hypothesized that with emerging multidrug resistant organisms there may be an increasing risk of infectious complications . MATERIAL S AND METHODS In a 5 % r and om sample of Medicare participants in SEER ( Surveillance , Epidemiology and End Results ) regions from 1991 to 2007 we compared 30-day hospitalization rates and ICD-9 primary diagnosis codes for admissions between 17,472 men who underwent prostate biopsy and 
    Output:
    
agent
Widespread use of fluoroquinolone prophylaxis may be associated with an increase in resistant Escherichia coli strains , posing a potentially major health issue in the future .
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To compare , prospect ively , 4 different schemes of antibiotic prophylaxis previously to transrectal prostate biopsy . MATERIAL S AND METHODS 257 patients were r and omized in 4 groups : Group I : single dose of ciprofloxacin 2 hours before the procedure ; Group II : ciprofloxacin 3 days ; Group III : chloramphenicol 3 days ; and Group IV : norfloxacin 3 days . The complication rate was assessed in a blind way on the third and on the thirtieth days through a question naire . Groups were compared by the qui-square method and , in small sample s , by the Fisher method , with statistical significance of 95 % . RESULTS Complications index throughout the sample differed between the 4 groups of patients under study , being 3.1 % for group I , 2.1%for group II , 18.3 % for group III and 10.5 % for group IV . Schemes employing ciprofloxacin were statistically superior to those that used norfloxacin or chloramphenicol ( p < 0.05 ) . There was no difference between a single dose and 3 days of ciprofloxacin ( p > 0.05 ) . CONCLUSION Schemes using ciprofloxacin presented better results in prophylaxis previously to prostate biopsy . We recommend using a single dose of ciprofloxacin due to its posologic ease and low cost , associated with a therapeutic response equivalent to 3-day regimens Purpose To compare the antibiotic prophylaxis based on quinolone administered orally with a combination of cephalosporin administered periprostatically and a fluoroquinolone orally , in terms of post-prostate bioptic infectious complication rates in those men undergoing transrectal ultrasound-guided prostate biopsy ( TRUS gpb ) . Methods In a prospect i ve , r and omized , double-blind study , 150 consecutive patients were r and omized to receive 10 ml lidocaine 1 % in Group A and ceftriaxone 1 g diluted in a solution of 10 ml of lidocaine 1 % in Group B , before TRUS gpb . All signed the informed consent . The men were asked to grade the pain using a ten points visual analogue scale close after TRUS gpb . In a telephone interview at 3 and 6 days , they were asked about early and late complications , assessing rectal bleeding , urinary retection , fewer , haematuria , urethral bleeding and hematospermia . Results Of the 150 men enrolled , 135 , 70 in Groups A and 65 in Group B , completed the study . Four men ( 5.7 % ) in Group A developed sepsis after TRUS gpb requiring hospital admission and intravenous antibiotic treatment , while none in Group B. Escherichia coli was the only organism isolated . The mean pain score was 2.76 ± 1.69 and 1.73 ± 1.26 for Group A and B , respectively ( p = 0.08 ) . Complications , evaluated at 3 and 6 days after the procedure through a telephone interview , were similar in both Groups . Conclusions The antibiotic prophylaxis based on the combination of ceftriaxone administered periprostatically and ciprofloxacin orally is able to offer a best control on infections caused by fluoroquinolone-resistant E. coli Transrectal biopsy is one of the more popular methods for the diagnosis of prostatic cancer . However , there is disagreement as to whether the use of prophylactic antimicrobials decreases the incidence of fever and urinary tract infections , which may follow this procedure . A prospect i ve r and omized double-blind study involving 63 patients was instituted to determine the efficacy of carbenicillin indanyl sodium in reducing these complications . The protocol consisted of administration of 2 tablets of 4 times daily of a placebo or the treatment drug 24 hours before and after biopsy . Clean catch urine cultures were obtained 24 hours before biopsy and at 48 hours and 2 weeks after the procedure . Blood cultures were performed 15 minutes after biopsy . In addition , clinical parameters were monitored closely in the hospital for 48 hours after biopsy . A total of 48 patients was considered evaluable . Of 23 patients who received the study drug 2 ( 8.6 per cent ) had positive urine cultures at 48 hours compared to 9 of 25 ( 36 per cent ) from the placebo group . A similar result was observed from the 2-week culture data , in which 2 of 23 patients ( 8.6 per cent ) in the treatment group had positive urine cultures as opposed to 5 of 25 ( 20 per cent ) receiving the placebo .  Fever occurred in 48 per cent of the placebo and in 17 per cent of the carbenicillin groups . Our data indicate that prophylactic administration of carbenicillin indanyl sodium decreases the complications of fever and urinary tract infections following transrectal biopsy of the prostate BACKGROUND Infection is a serious adverse effect of  prostate biopsy ( P-Bx ) , and recent reports suggest an increasing incidence . OBJECTIVE The aim of this multinational multicentre study was to evaluate prospect ively the incidence of infective complications after P-Bx and identify risk factors . DESIGN , SETTING , AND PARTICIPANTS The study was performed as an adjunct to the Global Prevalence Study of Infections in Urology ( GPIU ) during 2010 and 2011 . Men undergoing P-Bx in participating centres during the 2-wk period commencing on the GPIU study census day were eligible . OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Baseline data were collected and men were question ed regarding infective complications at 2 wk following their biopsy . The Fisher exact test , Student t test , Mann-Whitney U test , and multivariate regression analysis were used for data analysis . RESULTS AND LIMITATIONS A total of 702 men from 84 GPIU participating centres worldwide were included . Antibiotic prophylaxis was administered prior to biopsy in 98.2 % of men predominantly using a fluoroquinolone ( 92.5 % ) . Outcome data were available for 521 men ( 74 % ) . Symptomatic urinary tract infection ( UTI ) was seen in 27 men ( 5.2 % ) , which was febrile in 18 ( 3.5 % ) and required hospitalisation in 16 ( 3.1 % ) . Multivariate analysis did not identify any patient subgroups at a significantly higher risk of infection after P-Bx . Causative organisms were isolated in 10 cases ( 37 % ) with 6 resistant to fluoroquinolones . The small sample size per participating site and in compared with other studies may have limited the conclusions from our study . CONCLUSIONS Infective complications after transrectal P-Bx are important because of the associated patient morbidity . Despite antibiotic prophylaxis , 5 % of men will experience an infective complication , but none of the possible factors we examined appeared to increase this risk . Our study confirms a high incidence of fluoroquinolone resistance in causative bacteria OBJECTIVE Prostate biopsy is a frequent diagnostic measure to detect prostatic conditions , including primarily prostate cancer . Its performance does not follow a pattern , mainly regarding preparation for the examination through antimicrobial prophylaxis . The aim of this study is to compare the efficiency of short and long term antimicrobial prophylaxis in transrectal ultrasound-guided prostate biopsies . MATERIAL S AND METHODS A clinical study was conducted with a total of 140 patients su bmi tted to prostate biopsy with transrectal ultrasonographic control . Patients were r and omly separated in two groups : Group 1 receiving norfloxacin 400 mg single dose before the procedure and Group 2 receiving norfloxacin 400 mg initiating before the procedure and then bid up to 6 doses . Efficiency control was determined by the incidence of urinary tract infection ( UTI ) and complications in both groups after statistical analysis . RESULTS The incidence of minor complications in our study was 75 % , consistent with data found in the literature . Among the patients with diagnosis of simple UTI , 23 % belonged to Group 1 and 8 % to Group 2 ( p=0.08 ) . Among the patients with complicated UTI , 37 % belonged to Group 1 and none belonged to Group 2 ( p=0.44 ) . CONCLUSIONS Several advances made transrectal ultrasound-guided prostate biopsies a useful and safe diagnostic tool in the workup of urologic patients . There is no optimal prophylactic preparation to the performance of this procedure . Long term antimicrobial prophylaxis presents a trend toward lower incidence of infectious complications Background Transrectal ultrasound-guided prostate biopsies ( TRUSBx ) , in spite of being one of the most frequently performed urological office procedures , are associated with a spectrum of complications , most significantly including infection . The aim of the study is to evaluate the prevalence of fluoroquinolone-resistant bacteria in rectal swabs from our local population prior to TRUSBx and to identify risk factors among a patient population harboring fluoroquinolone-resistant organisms . Methods We prospect ively included 541 men who were su bmi tted for TRUSBx in our center from March 2011 to June 2015 . The indications for TRUSBx were an elevated prostate-specific antigen level and /or abnormal digital rectal exam . All patients were r and omly divided into two groups : Group 1 ( n = 279 cases ) who received st and ard empirical prophylactic antibiotics and Group 2 who received targeted prophylaxis based on a rectal swab culture and susceptibility result . Differences in risk factors between quinolone-resistant and nonresistant patients were compared . Univariate and multivariate analyses were performed to identify independent potential risk factors associated with fluoroquinolone-resistant rectal flora . Results Sixteen out of 271 men developed infectious complications after TRUSBx in the group receiving st and ard empirical prophylaxis ( 5.7 % ) . No men in the group who received targeted prophylactic antibiotic guided by rectal swab developed infectious complications . Among the 262 patients who underwent prebiopsy rectal swab cultures , 76 men ( 29 % ) displayed fluoroquinolone-resistant rectal flora ( 29 % ) . In the multivariate analysis , a history of antibiotic exposure before prostate biopsy was the only independent factor associated with an increased risk of fluoroquinolone resistance . Conclusion Determining the prevalence of fluoroquinolone resistance in rectal flora has important implication s in the selection of targeted prophylactic antibiotic regimens . Antimicrobial profiles guided by rectal swabs may prove useful to optimize prophylaxis prior to TRUSBx ; this strategy is effective at reducing the rates of infectious complications , including sepsis , especially in men at higher risk of infectious complications PURPOSE Prostate biopsy related infectious complications are associated with significant morbidity . The risk of infectious complications in patients with prostate cancer on active surveillance remains under studied . MATERIAL S AND METHODS A total of 591 consecutive men who underwent prostate biopsy were prospect ively enrolled in a study evaluating prostate biopsy related complications between January 2011 and January 2012 . Of these men 403 were previously diagnosed with prostate cancer and were included in this study . They underwent a 14-core transrectal ultrasound guided prostate biopsy as part of an active surveillance regimen . A nurse contacted all men within 14 days of biopsy , and information was collected on potential complications , antibiotics received and bacterial culture results . RESULTS Fourteen patients ( 3.5 % ) had infectious complications including 13 requiring hospitalization . Five patients had positive urine cultures , and fluoroquinolone resistant isolates were identified in 4 patients , including 2 with extended spectrum beta-lactamase producing isolates . We evaluated the impact of risk factors including diabetes , benign prostatic hyperplasia and antibiotic regimen . However , only the number of previous prostate biopsies was significantly associated with an increased risk of infectious complications ( p = 0.041 ) . For every previous biopsy the odds of an infection increased 1.3 times ( OR 1.33 , 95 % CI 1.01 - 1.74 ) . CONCLUSIONS In men with prostate cancer on active surveillance the number of previous prostate biopsies is associated with a significant risk of infectious complications and every previous biopsy increases the risk of infectious complication . Fluoroquinolone resistant and extended spectrum beta-lactamase producing isolates represent the most commonly identified organisms . Men with prostate cancer on active surveillance should be informed of the risks associated with serial repeat prostate biopsies PURPOSE More than 1 million prostate biopsies are performed annually among Medicare beneficiaries . We determined the risk of serious complications requiring hospitalization . We hypothesized that with emerging multidrug resistant organisms there may be an increasing risk of infectious complications . MATERIAL S AND METHODS In a 5 % r and om sample of Medicare participants in SEER ( Surveillance , Epidemiology and End Results ) regions from 1991 to 2007 we compared 30-day hospitalization rates and ICD-9 primary diagnosis codes for admissions between 17,472 men who underwent prostate biopsy and 
    Output:
    