Widespread use of fluoroquinolone prophylaxis may be associated with an increase in resistant Escherichia coli strains , posing a potentially major health issue in the future .
INTRODUCTION Transrectal ultrasound-guided biopsies ( TRUS-gb ) are associated with both mild and serious complications .
Prophylactic antibiotics reduce the risk of septicaemia and mortality ; however , no international consensus exists on the timing and duration of antibiotics , including the optimal drug strategy .
We review ed the current evidence supporting use of prophylactic antibiotics and the risk of complications following prostate biopsies .
Fluoroquinolone-resistant E. coli in intestinal flora of patients undergoing transrectal ultrasound-guided prostate biopsy--should we reassess our practices for antibiotic prophylaxis?
Although the estimate of the incidence of sepsis following  transrectal ultrasound-guided prostate biopsy ( TRUSPB ) is low , fluoroquinolone-resistant infections after prostate biopsy are being increasingly noted . This study was aim ed at determining the prevalence of faecal carriage of fluoroquinolone-resistant Escherichia coli strains before TRUSPB and at evaluating potential predisposing risk factors . The incidence of sepsis after prostate biopsy was determined , and our routine practice for antibiotic prophylaxis for TRUSPB was evaluated . A prospect i ve study was conducted in 342 consecutive patients undergoing prostate biopsy between December 2009 and July 2010 . Before TRUSPB , a rectal swab was cultured . The correlation between the presence of fluoroquinolone-resistant strains and plausible risk factors was investigated by the use of a question naire . Of the 236 patients included , 22.0 % ( 52/236 ) harboured ciprofloxacin-resistant E. coli strains . The use of fluoroquinolones in the 6 months before biopsy was associated with an increased risk of faecal carriage of fluoroquinolone-resistant E. coli strains ( p < 0.01 ) . Faecal carriage of fluoroquinolone-resistant E. coli strains was an important risk factor for infectious complications after TRUSPB ( p < 0.01 ) . In conclusion , a significant number of patients have faecal carriage of fluoroquinolone-resistant E. coli strains ( 22.0 % ) before TRUSPB . The use of fluoroquinolones in the previous 6 months before biopsy is a risk factor for faecal carriage of fluoroquinolone-resistant E. coli strains and for infectious complications after TRUSPB . Hence , the universal administration of fluoroquinolones should be reconsidered
Widespread use of fluoroquinolone prophylaxis may be associated with an increase in resistant Escherichia coli strains , posing a potentially major health issue in the future .
INTRODUCTION Transrectal ultrasound-guided biopsies ( TRUS-gb ) are associated with both mild and serious complications .
Prophylactic antibiotics reduce the risk of septicaemia and mortality ; however , no international consensus exists on the timing and duration of antibiotics , including the optimal drug strategy .
We review ed the current evidence supporting use of prophylactic antibiotics and the risk of complications following prostate biopsies .