Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor
To the Editor.—Transurethral procedures, including cystoscopy, urethral dilation, and transurethral resection of the prostate, have been associated with bacteremia frequencies as high as 17%, 24%, and 31%, respectively.1 For this reason, the American Heart Association (AHA) recommends antibiotic prophylaxis for all patients with high- or moderate-risk cardiac conditions who undergo transurethral procedures.2 On the other hand, the rate of bacteremia associated with gastrointestinal endoscopy is virtually always less than 10%, and mucosal biopsy does not increase this.2 Taking into consideration this rather low frequency of bacteremia associated with gastrointestinal endoscopy, the AHA recommends optional prophylaxis only for patients with high-risk cardiac conditions but not for those with moderate-risk conditions.
Basaran G. Endocarditis Prophylaxis for Transrectal Prostatic Biopsy. JAMA. 1998;280(22):1908. doi:10-1001/pubs.JAMA-ISSN-0098-7484-280-22-jac80017