Firing at a fly with a shotgun

The use of antibiotic prophylaxis during transrectal ultrasound-guided prostate biopsy is state of the art [1]. Currently, fluoroquinolones, cotrimoxazole and targeted antibiotic prophylaxis are the recommended approaches [2]. There is less consensus how long the drug administration should last. Unlike antibiotic prophylaxis, no method of bowel preparation has been agreed upon so far. It seems logical that some form of bowel cleansing can help to decrease the amount of bacteria present in the rectum before biopsy and lead to a lower rate of infectious complications. The present study by Yildirim et al. [3] aims to answer the question, which method of bowel preparation before prostate biopsy yields better outcomes in terms of infectious complications. A self-administered phosphate enema as well as sennasoid a-b laxatives were the forms of bowel preparation used. Phosphate enemas directly stimulate smooth muscles of the rectum in order to eliminate stool; sennasoid laxatives induce fluid secretion from the mucosa and colonic contractions. Additionally, a seven-day antibiotic course was used before and after prostate biopsy. Urosepsis occurred in 1.8% and 3.6% of the Firing at a fly with a shotgun