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Prostate CancerNCT03879486

Infectious Outcomes of Povidone-iodine Rectal Cleansing Plus Formalin Disinfection of Needle During Prostate Biopsy

A study testing Intrarectal povidone-iodine cleansing plus formalin disinfection of needle tip during transrectal ultrasound guided prostate biopsy in people with Prostate Cancer and Prostatic Neoplasms, run by Hospital de Transplante Doutor Euryclides de Jesus Zerbini at 1 site in Brazil.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The main purpose of this study is to compare the infectious outcomes of intrarectal povidone-iodine cleansing plus formalin disinfection of needle tip during transrectal ultrasound guided prostate biopsy. The secondary objective is to evaluate predictive factors of infectious complications after prostate biopsy. Read more about this study

Who is it for?
Ages 50 to 80 years, men only
What is being tested?
Intrarectal povidone-iodine cleansing plus formalin disinfection of needle tip during transrectal ultrasound guided prostate biopsy
Could I receive a placebo?
No, everyone receives an active treatment
How many people
1,257 participants
Where
1 siteBrazil
Study dates
31 May 2017to 24 Jul 2019
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 50 to 80 years
  • Men only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Signature of the consent term;
  • Agreement with the study follow-up protocol;
  • Indication of biopsy due to increased PSA (> 2.5), abnormal rectal touch or patients under active surveillance protocol

Who cannot join

  • Existence of cognitive deficit that impedes the reading and comprehension of the EHIC;
  • Allergy to ciprofloxacin or iodine

Trial locations and contacts

1 site in 1 country.

Brazil1 site
  • Hospital de Transplantes Euryclides de Jesus Zerbini

    São Paulo, 01401901

Other trials in Brazil

About this study

Official title: A Randomized Controlled Trial to Investigate the Infectious Outcomes of Intrarectal Povidone-iodine Cleansing Plus Formalin Disinfection of Needle Tip During Transrectal Ultrasound Guided Prostate Biopsy

The main purpose of this study is to compare the infectious outcomes of intrarectal povidone-iodine cleansing plus formalin disinfection of needle tip during transrectal ultrasound guided prostate biopsy. The secondary objective is to evaluate predictive factors of infectious complications after prostate biopsy. Data will be prospectively collected from patients who will undergo prostate biopsy in a single high volume urology center. The patients will be randomized to two different groups: group A - rectal cleansing and disinfection of the needle tip vs group B - controls.

Read the detailed description

Prostate cancer is the most common neoplasm of solid organs in Brazil. Definitive diagnosis of the tumor is established through prostate biopsy, indicated in patients with elevated levels of PSA or suspicious rectal examination. The ultrasound or MRI-guided prostate biopsy is mostly performed through the transrectal route worldwide. Although it is a relatively safe procedure, transrectal prostate biopsy (TRUSB) can present several complications, such bleeding, acute urinary retention or infection. Infectious complications are an important concern for the urologist and have different presentation, ranging from isolated fever to severe sepsis. Antibiotic prophylaxis is an effective widely used practice, however, due to increasing rates of bacterial resistance, there is a growing trend in the incidence of infectious complications after TRUSB. Therefore, alternative strategies to decrease infections rates following biopsies are welcome. Our aim was to compare the infectious complications of intrarectal povidone-iodine cleansing associated to formalin disinfection of biopsy needle tip at prostate biopsy.

A prospective controlled study will be conducted enrolling 1152 consecutive prostate biopsies in a single center high volume urology Brazilian Public Hospital. The patients will be randomized at a 1: 1 ratio for two different groups: group A - rectal cleansing and disinfection of the needle tip vs. Group B - controls at transrectal ultrasound guided prostate biopsy. Patients will obtain a urine culture 48 hours after biopsy and complete a telephone interview 7 days after undergoing the procedure. The primary endpoint will be the rate of infectious complications, defined as 1 or more of the following events: fever ≥37.8 ºC; urinary tract infection (UTI) or sepsis (standardized definition). We will also evaluate the predictive factors of infectious complications

Being tested
Intrarectal povidone-iodine cleansing plus formalin disinfection of needle tip during transrectal ultrasound guided prostate biopsy
Medical subject headings
Prostatic Neoplasms, Prostatitis

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Intrarectal povidone-iodine cleansing plus formalin disinfection of needle tip during transrectal ultrasound guided prostate biopsyOther

    The examiner will use a gauze soaked and saturated with iodopovidone and perform a mechanical friction motion on the anterior wall of the rectum, at least 5 times from one margin to another of the prostate laterally-laterally. A period of two (2) minutes shall be waited from the prophylactic cleaning of the rectum to the beginning of the biopsy. The examiner will use a technique of disinfecting the 10% formaldehyde biopsy needle without manual contact by soaking the distal 3 cm of the needle directly into a vial containing the bactericidal solution between obtaining the different fragments. An individual bottle will be used for each patient

Study groups in NCT03879486
Study groupRoleWhat they receive
PVPI interventionExperimentalrectal cleansing and disinfection of the needle tip at transrectal ultrasound guided prostate biopsy
Receives: Other: Intrarectal povidone-iodine cleansing plus formalin disinfection of needle tip during transrectal ultrasound guided prostate biopsy
Control armNo interventioncontrols at transrectal ultrasound guided prostate biopsy

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Infectious complications

    compare the infectious outcomes of intrarectal povidone-iodine cleansing plus formalin disinfection of needle tip during transrectal ultrasound guided prostate biopsy

    Measured: 1 week

Secondary outcomes (1)
  1. evaluate predictive factors of infectious complications after prostate biopsy.

    evaluate predictive factors of infectious complications after prostate biopsy.

    Measured: 1 week

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted18 Mar 2019
  2. Study start31 May 2017
  3. Primary completion24 Jul 2019
  4. Study completion24 Jul 2019

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Single group
Model description
Prospective controlled study
Masking
None (open label)
Enrolment
1,257 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03879486
Sponsor's protocol ID
BIOPSY1
Status last verified
Mar 2020
First submitted
1 Nov 2018
Last updated
19 Mar 2020
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Noguchi M, Matsuoka K, Koga H, Kanetake H, Nakagawa M, Naito S. A questionnaire survey of patient preparation and techniques for prostate biopsy among urologists in the Kyushu and Okinawa regions of Japan. Int J Clin Oncol. 2006 Oct;11(5):390-5. doi: 10.1007/s10147-006-0592-3.

    PubMed 17058137
  • Schroder FH, Hugosson J, Roobol MJ, Tammela TL, Zappa M, Nelen V, Kwiatkowski M, Lujan M, Maattanen L, Lilja H, Denis LJ, Recker F, Paez A, Bangma CH, Carlsson S, Puliti D, Villers A, Rebillard X, Hakama M, Stenman UH, Kujala P, Taari K, Aus G, Huber A, van der Kwast TH, van Schaik RH, de Koning HJ, Moss SM, Auvinen A; ERSPC Investigators. Screening and prostate cancer mortality: results of the European Randomised Study of Screening for Prostate Cancer (ERSPC) at 13 years of follow-up. Lancet. 2014 Dec 6;384(9959):2027-35. doi: 10.1016/S0140-6736(14)60525-0. Epub 2014 Aug 6.

    PubMed 25108889
  • Zaytoun OM, Vargo EH, Rajan R, Berglund R, Gordon S, Jones JS. Emergence of fluoroquinolone-resistant Escherichia coli as cause of postprostate biopsy infection: implications for prophylaxis and treatment. Urology. 2011 May;77(5):1035-41. doi: 10.1016/j.urology.2010.12.067. Epub 2011 Mar 21.

    PubMed 21420152
  • Djavan B, Waldert M, Zlotta A, Dobronski P, Seitz C, Remzi M, Borkowski A, Schulman C, Marberger M. Safety and morbidity of first and repeat transrectal ultrasound guided prostate needle biopsies: results of a prospective European prostate cancer detection study. J Urol. 2001 Sep;166(3):856-60.

    PubMed 11490233
  • Zani EL, Clark OA, Rodrigues Netto N Jr. Antibiotic prophylaxis for transrectal prostate biopsy. Cochrane Database Syst Rev. 2011 May 11;2011(5):CD006576. doi: 10.1002/14651858.CD006576.pub2.

    PubMed 21563156
  • Lindstedt S, Lindstrom U, Ljunggren E, Wullt B, Grabe M. Single-dose antibiotic prophylaxis in core prostate biopsy: Impact of timing and identification of risk factors. Eur Urol. 2006 Oct;50(4):832-7. doi: 10.1016/j.eururo.2006.05.003. Epub 2006 May 16.

    PubMed 16750292
  • Lee SJ. Infection after transrectal ultrasound-guided prostate biopsy. Korean J Urol. 2015 May;56(5):346-50. doi: 10.4111/kju.2015.56.5.346. Epub 2015 Apr 6.

    PubMed 25964834
  • Carignan A, Roussy JF, Lapointe V, Valiquette L, Sabbagh R, Pepin J. Increasing risk of infectious complications after transrectal ultrasound-guided prostate biopsies: time to reassess antimicrobial prophylaxis? Eur Urol. 2012 Sep;62(3):453-9. doi: 10.1016/j.eururo.2012.04.044. Epub 2012 May 3.

    PubMed 22575912
  • Feliciano J, Teper E, Ferrandino M, Macchia RJ, Blank W, Grunberger I, Colon I. The incidence of fluoroquinolone resistant infections after prostate biopsy--are fluoroquinolones still effective prophylaxis? J Urol. 2008 Mar;179(3):952-5; discussion 955. doi: 10.1016/j.juro.2007.10.071. Epub 2008 Jan 22.

    PubMed 18207185
  • Liss MA, Chang A, Santos R, Nakama-Peeples A, Peterson EM, Osann K, Billimek J, Szabo RJ, Dash A. Prevalence and significance of fluoroquinolone resistant Escherichia coli in patients undergoing transrectal ultrasound guided prostate needle biopsy. J Urol. 2011 Apr;185(4):1283-8. doi: 10.1016/j.juro.2010.11.088. Epub 2011 Feb 22.

    PubMed 21334021
  • Duplessis CA, Bavaro M, Simons MP, Marguet C, Santomauro M, Auge B, Collard DA, Fierer J, Lesperance J. Rectal cultures before transrectal ultrasound-guided prostate biopsy reduce post-prostatic biopsy infection rates. Urology. 2012 Mar;79(3):556-61. doi: 10.1016/j.urology.2011.09.057.

    PubMed 22386395
  • Fahmy A, Rhashad H, Mohi M, Elabbadie A, Kotb A. Optimizing prophylactic antibiotic regimen in patients admitted for transrectal ultrasound-guided prostate biopsies: A prospective randomized study. Prostate Int. 2016 Sep;4(3):113-7. doi: 10.1016/j.prnil.2016.06.001. Epub 2016 Jul 1.

    PubMed 27689069
  • Steensels D, Slabbaert K, De Wever L, Vermeersch P, Van Poppel H, Verhaegen J. Fluoroquinolone-resistant E. coli in intestinal flora of patients undergoing transrectal ultrasound-guided prostate biopsy--should we reassess our practices for antibiotic prophylaxis? Clin Microbiol Infect. 2012 Jun;18(6):575-81. doi: 10.1111/j.1469-0691.2011.03638.x. Epub 2011 Sep 29.

    PubMed 21958149
  • Taylor AK, Zembower TR, Nadler RB, Scheetz MH, Cashy JP, Bowen D, Murphy AB, Dielubanza E, Schaeffer AJ. Targeted antimicrobial prophylaxis using rectal swab cultures in men undergoing transrectal ultrasound guided prostate biopsy is associated with reduced incidence of postoperative infectious complications and cost of care. J Urol. 2012 Apr;187(4):1275-9. doi: 10.1016/j.juro.2011.11.115. Epub 2012 Feb 16.

    PubMed 22341272
  • Jeon SS, Woo SH, Hyun JH, Choi HY, Chai SE. Bisacodyl rectal preparation can decrease infectious complications of transrectal ultrasound-guided prostate biopsy. Urology. 2003 Sep;62(3):461-6. doi: 10.1016/s0090-4295(03)00470-9.

    PubMed 12946747

Questions about this trial

What is this clinical trial studying?

A study testing Intrarectal povidone-iodine cleansing plus formalin disinfection of needle tip during transrectal ultrasound guided prostate biopsy in people with Prostate Cancer and Prostatic Neoplasms, run by Hospital de Transplante Doutor Euryclides de Jesus Zerbini at 1 site in Brazil.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 19 Mar 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Brazil. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Infectious complications (time frame: 1 week). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03879486, which also lists 24 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 19 Mar 2020.

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