Compliance with Australian splenectomy guidelines in patients undergoing post‐traumatic splenectomy at a tertiary centre

Stable post-TRUS biopsy sepsis rates and antibiotic resistance over 5 years in patients from Newcastle, New South Wales TO THE EDITOR: Sepsis after transrectal ultrasound (TRUS)guided prostate biopsy is a potentially serious complication.Antibiotic prophylaxis reduces the risk of sepsis; however, practices are highly variable among urologists.Several reports show increasing incidence of bacterial resistance in patients with sepsis after TRUSguided biopsy. [1]2][3] Preprocedure screening of high-risk patients using cultures from rectal swabs would allow targeted prophylaxis. 4,5 We performed a retrospective audit of all men undergoing a TRUS-guided prostate biopsy by one of nine urologists in Newcastle, New South Wales, to assess the incidence of bacteraemia and changes in antimicrobial susceptibility.Unique patient data were collected retrospectively from private and public hospital records, including data on positive blood cultures from Hunter Area, Douglass Hanly Moir, Laverty and Healthscope pathology services.Patient and pathology records were crossreferenced and data were analysed using Microsoft Excel.This clinical audit did not require ethics committee approval, in accord with the NSW Health policy on authorisation to commence with resistance to ciprofloxacin and gentamicin (5/4218; 0.1%) implies that there is no utility in screening with cultures from rectal swabs before TRUS biopsy in the population we studied.It remains essential to administer antibiotics prophylactically 1 hour before the procedure and at an appropriate dose to maximise sepsis prevention.