Fluoroquinolone Resistance Level in Rectal Swab Taken Before Transrectal Ultrasound Prostate Biopsy

Objective: It has been shown that antibiotic prophylaxis before transrectal ultrasound prostate biopsy (TRUS-Bx) reduces the incidence of post-biopsy infectious complications. Without the superiority of a particular antibiotic regimen, there are differences in the antibiotic regimens used by clinics. However, recently, there have been serious concerns about TRUS-Bx-related infectious complications due to the increase in fluoroquinolone (FQ)-resistant bacterial strains. To overcome this global problem, alternative antibiotic prophylaxis should be investigated and appropriate antibiotic management should be applied in patients who will undergo TRUS-Bx. This study aimed to determine the antibiotic susceptibility of the rectal flora based on rectal cultures before TRUS-Bx, to systematically determine the basic prevalence of FQ resistance, to investigate the relationship between FQ resistance and the risk of infection after TRUS-Bx, and to determine the susceptibility of Fosfomycin and trimethoprim-sulfamethoxazole (TMP-SMX) as an alternative to the FQ group.Materials and Methods: Rectal swab cultures were taken from each patient to undergo TRUS-Bx two days before the procedure. Two daily doses of 500 mg ciprofloxacin were given orally for one week, starting one hour before the procedure. All patients underwent 12 core biopsies.Results: Antibiograms obtained from rectal swabs showed sensitivity to FQ in 78 patients (89.7%), to Fosfomycin in 85 patients (97.7%), to TMP-SMX in 78 patients (89.7%).Conclusion: Although different antibiotic prophylaxis methods are discussed due to FQ resistance in today's medical practices, FQ sensitivity continues at a high rate of 89.7% in our region and still seems to be a viable prophylaxis method.