title: Fluoroquinolone-resistant acute prostatitis requiring hospitalization after transrectal prostate biopsy: effect of previous fluoroquinolone use as prophylaxis or long-term treatment.
abstract: OBJECTIVE
  This study aims to scrutinize the hospitalized patients with the diagnosis of acute prostatitis after transrectal ultrasound-guided biopsy of the prostate (TRUSBP) focusing their history of previous antibiotic use, clinical pictures, microbiologic features, and resistance patterns of the isolates.
  
  
  METHODS
  A retrospective evaluation of the records between 2005 and 2010 revealed 13 patients. All patients received ciprofloxacin 500 mg twice a day starting from the day before TRUSBP for 5 days.
  
  
  RESULTS
  Positive 13 urine and 7 blood samples (Escherichia coli in 12 patients, Enterococcus species in one) were evaluated for resistance patterns. All were resistant to fluoroquinolones. Extended spectrum beta-lactamase producing E. coli isolated in 4 patients were treated with carbapenems. Empirical ceftriaxone was shifted to carbapenem (4 patients), vancomycin (1 patient). Empirical carbapenem was maintained in 5 patients. Seven patients with elevated PSA received fluoroquinolones for 4 weeks before TRUSBP on the assumption that they had subclinical infectious prostatitis. Previous exposure to fluoroquinolones did not lead to important differences in respect to the studied parameters.
  
  
  CONCLUSIONS
  The prompt initiation of effective treatment is essential to decrease morbidity and mortality. Empirical treatment would be a second or third generation cephalosporins, or carbapenems according to clinical severity of patients.
authors.affiliation: Department of Urology, Maltepe University School of Medicine, Feyzullah Caddesi, No: 39, 34843 Istanbul, Turkey. ekicimiami@yahoo.com
authors.forename: Sinan
authors.initials: S
authors.lastname: Ekici
authors.forename: Melahat
authors.initials: M
authors.lastname: Cengiz
authors.forename: Güven
authors.initials: G
authors.lastname: Turan
authors.forename: Esra Ergün
authors.initials: EE
authors.lastname: Alış
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000890:Anti-Infective Agents / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis / Q000009:adverse effects*; D001706:Biopsy / Q000009:adverse effects*; D015780:Carbapenems / Q000627:therapeutic use; D002443:Ceftriaxone / Q000627:therapeutic use; D002939:Ciprofloxacin / Q000627:therapeutic use; D024901:Drug Resistance, Multiple, Bacterial; D016983:Enterococcus; D004926:Escherichia coli; D004927:Escherichia coli Infections / Q000188:drug therapy; D024841:Fluoroquinolones / Q000627:therapeutic use*; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood; D011472:Prostatitis / Q000097:blood / Q000188:drug therapy* / Q000382:microbiology*; D012189:Retrospective Studies; D014640:Vancomycin / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D015780:Carbapenems; D024841:Fluoroquinolones; D002939:Ciprofloxacin; D014640:Vancomycin; D002443:Ceftriaxone; D017430:Prostate-Specific Antigen