We would like to thank the author of the editorial comment for the thorough review of our manuscript and for highlighting techniques to counter the current rise in prostate biopsy infections. Additionally, the rise in active surveillance will assuredly lead more patients "at risk" who have previous fluoroquinolone (FQ) exposure from past biopsies. In addition to improving patient selection and accuracy of prostate biopsies, a paradigm shift is needed regarding antimicrobial prophylaxis for trans-rectal prostate biopsy.
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