Inclusion Criteria:  Patient with lower urinary tract symptoms aged >45 years with either PSA levels of 4.0 ng/mL or higher or abnormal findings on digital rectal examination (DRE) Patient with a negative initial urine culture / urinalysis test  Exclusion Criteria:  Patients who refuses to undergo transperineal prostate biopsy Patients who refuses to participate in the research Patient who is unable to communicate effectively Patient with a documented history of cotrimoxazole allergy Patient who has consumed antibiotics for other indications prior to undergoing prostate biopsy Patient with urinary tract infection symptoms prior to undergoing prostate biopsy Patient with a history of immunodeficiency disorders or long-term corticosteroid use Patient with a history of prostate cancer Patient with a history of prior prostate biopsy