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The Scientific World Journal
Volume 2013, Article ID 452107, 6 pages
Clinical Study

Quinolone Prophylaxis in Transrectal Ultrasound Guided Prostate Biopsy: An Eight-Year Single Center Experience

1Department of Urology, National Taiwan University Hospital, College of Medicine, National Taiwan University, No. 7, Chung Shan S. Road (Zhongshan S. Road), Zhongzheng District, Taipei City 10002, Taiwan
2Department of Urology, Cardinal Tien Hospital, College of Medicine, Fu Jen Catholic University, No. 362, Zhongzheng Road, Xindian District, New Taipei City 231, Taiwan
3Division of Urology, Department of Surgery, Far Eastern Memorial Hospital, No. 21, Section 2, Nanya S. Road, Banqiao District, New Taipei City 220, Taiwan
4Department of Urology, Tzu Chi General Hospital, No. 707, Section 3, Chung Yang Road, Hualien 970, Taiwan

Received 18 August 2013; Accepted 1 October 2013

Academic Editors: R. L. Davis and W. Kassouf

Copyright © 2013 Bing-Juin Chiang et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


We retrospectively evaluated the efficacy of prophylaxis with pipemidic acid and levofloxacin in transrectal ultrasound guided prostate biopsy (TRUSP-Bx). From January 2002 to December 2004, patients receiving oral pipemidic acid 500 mg twice daily for three days with or without a preoperative intravenous cefazolin 1 gm injection comprised group A. Between January 2005 and December 2009, patients receiving oral levofloxacin 500 mg one hour before biopsy comprised group B. We calculated the annual febrile urinary tract infection (fUTI) rates. Patients’ characteristics, including age, prophylactic antibiotics, biopsy core numbers, pathologic results, PSA, and the spectrums and susceptibility of pathogens, were also evaluated. A total of 1313 (35.5%) patients belonged to group A, while 2381 (64.5%) patients belonged to group B. Seventy-three patients experienced postoperative infectious complications. There was a significant difference in the fUTI rate between groups A and B (3.7% versus 1.0%, ). The yearly fUTI rates varied from 0.6 to 3.9% between 2002 and 2009. Of the 73 patients with fUTI, those receiving levofloxacin prophylaxis were more likely to harbor fluoroquinolone-resistant pathogens ( ). E. coli was the most common pathogen in both groups. Levofloxacin remains effective and appears superior to pipemidic acid based prophylaxis.