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.