This is an excellent clinical review of a large number of patients who underwent transrectal ultrasound-guided prostate biopsy (TRUS-BP) during an almost 5-year period. All patients received ciprofloxacin, 500 mg twice daily for 5 days, starting 24 hours before the procedure. All patients underwent a minimum of a 12-core biopsy. The authors reviewed the infectious complications and noted that these occurred in 28 of 1339 patients (2.1%). A slightly greater (and statistically significant) incidence was found in patients undergoing repeat biopsy (6.8%) vs an initial biopsy (1.3%). Most of the patients (61%) had Escherichia coli as the cause of the infection, with 13 of 17 (76.5%) caused by extended-spectrum beta-lactamase (ESBL)-producing bacteria. Of these, 10 of 17 (58.9%) were due to ESBL-producing E. coli. These infections were resistant to flu-oroquinolone antibiotics.
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