Our study was part of a prospective survey for rectal colonization with fluoroquinolone-resistant Enterobacteriaceae in pre-prostate biopsy patients, which was done in part to examine the potential utility of screening rectal cultures in this context. We have encouraged use of prebiopsy rectal cultures to allow targeted prophylaxis. The targeted approach has the potential to (1) prevent infectious complications from fluoroquinolone-resistant E coli (the most common cause of infections after prostate biopsy), (2) limit the use of fluoroquinolones in patients who will not benefit from them due to colonization with resistant bacteria, and (3) avoid routine use of broader-spectrum agents, which would select for additional resistance and are unnecessary in most patients.
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