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December 9, 1998

Endocarditis Prophylaxis for Transrectal Prostatic Biopsy

Author Affiliations

Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor

JAMA. 1998;280(22):1908. doi:10-1001/pubs.JAMA-ISSN-0098-7484-280-22-jac80017

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.

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