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October 2003 Issue

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Biopsy Infection Research Published in Two Urology Journals

Published October 2003

Thomas Bell, MD, professor, urology surgery at the UC College of Medicine, has had two papers published in national journals in last three months. Both papers show that a pre-biopsy Fleet enema washes away bacteria in the rectum and prevents infection during a prostate biopsy test for cancer. Biopsy of the prostate is necessary to accurately diagnose prostate cancer.

A prostate biopsy is done through the rectal wall, which is normally an area of high bacterial contamination. Thousands of such biopsies are done yearly, and while using antibiotics to prevent infection may seem wise, no one has agreed on the antibiotic of choice, the dose or the number of days of medication. Based on a large sample that exceeded 2000 biopsies, these researchers found that a single dose of an antibiotic is efficacious and also cost effective. When applied, this practice can save millions of dollars.

"We also realized that the antibiotic we used provided only partial protection, based on the knowledge of the bacteria residing in the rectum," Dr. Bell said. "We suspect, because we saw no sepsis attributable to those type of organisms not affected by the antibiotic, that the Fleet enema we employed just prior to the biopsy provided a significant degree of protection. In over 2000 such patients none returned with a septic event."

The article detailing Dr. Bell's research was titled "Gastrostomy Button as Catherizable Urinary Stoma: Pilot Study," and was published in the September 2003 Journal of Urology.

Another article by Dr. Bell's team of researchers titled "Antimicrobial Prophylaxic and Patient Preparation for Transrectal Prostate Biopsy: Review of the Literature and Analysis of Cost-effectiveness," appeared in the May-June 2003 issue of Infections in Urology. This article reviewed research concerned with the effectiveness of using Fleet enemas to sanitize the rectal area in preparation for a prostate biopsy. The article also showed that lower infections equal lower costs of treatment for each patient. This was quite an extensive review and became the lead article.

Authors of the second article include: Dennis Bentley, MD, a medical resident in Akron; David Kitchens, MD, a UC resident; and Dr. Bell. Dennis Bentley was a UC medical student several years ago. Dr. Bell was his faculty advisor in this endeavor and collaborated on this paper with him even after Dr. Bentley matched for residency at Akron. Dr. Kitchens and Dr. Bell rewrote and edited this article numerous times since January.

"We had no idea that it would be the lead article," Dr. Bell said.

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