EARLY INFECTIOUS COMPLICATIONS WITH TRANSPONDER PLACEMENT FOR EXTERNAL BEAM RADIATION THERAPY FOR PROSTATE CANCER

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The high infectious complication rate reported by Berglund et al. is most likely to be a chance occurrence, and not some sort of beacon-specific infectious risk. Nonetheless, transrectal procedure-related infections are an increasing concern owing to antibiotic resistance. In our clinic, we place prostatic positional markers (gold seed or Calypso®) transperineally. The transperineal, template-guided route is more accurate and more amenable to adequate lidocaine infiltration [1]. Although we have no statistics to present, our team has had no infectious complications, despite the use of only a single 500 mg ciprofloxacin (pre-procedure) prophylaxis and no post-procedure medication. Needle insertion through cleansed perineal skin probably leads to a lower infection risk than the transrectal route. Rather than further escalate peri-procedural antibiotics, I would encourage other practitioners to switch from transrectal to transperineal marker insertion.

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