title: The effectiveness of single-dose fosfomycin as antimicrobial prophylaxis for patients undergoing transrectal ultrasound-guided biopsy of the prostate.
abstract: OBJECTIVE
  It was the aim of this study to evaluate the efficacy of single-dose fosfomycin prophylaxis as an alternative to fluoroquinolone-based prophylaxis in transrectal ultrasound-guided biopsy of the prostate (TRUSBP).
  
  
  METHODS
  We evaluated the records of 620 patients who had undergone TRUSBP from January 2010 to July 2011. Patients received a single dose of 3 g oral fosfomycin or a single dose of 500 mg oral levofloxacin or 500 mg oral ciprofloxacin twice daily administered for 5 days starting 1 day before the prophylaxis procedure. We reviewed all febrile and afebrile urinary tract infections (UTIs) within 1 month after TRUSBP.
  
  
  RESULTS
  Of the 620 patients, 19 (3.0%) developed febrile UTI and 51 (8.2%) developed afebrile UTI after biopsy. Of the 19 patients with febrile UTI, 1/19 (5.2%) received fosfomycin, 4/19 (21%) received levofloxacin and 14/19 (73.6%) received ciprofloxacin for prophylaxis. Of the 51 patients with afebrile UTI, 4/51 (7.8%) received fosfomycin, 8/51 (15.6%) received levofloxacin and 39/51 (76.4%) received ciprofloxacin for prophylaxis. There were a total of 10 fluoroquinolone-resistant infections, and all of them occurred after the ciprofloxacin or levofloxacin prophylaxis and none after fosfomycin prophylaxis.
  
  
  CONCLUSIONS
  The ease of use of fosfomycin, reducing the rate of fluoroquinolone-resistant infections and hospitalizations shows that it would be an alternative and effective drug for antimicrobial prophylaxis in TRUSBP.
authors.affiliation: Department of Urology, Dokuz Eylul University School of Medicine, Izmir, Turkey. sakirongun @ hotmail.com
authors.forename: Sakir
authors.initials: S
authors.lastname: Ongün
authors.forename: Güven
authors.initials: G
authors.lastname: Aslan
authors.forename: Vildan
authors.initials: V
authors.lastname: Avkan-Oguz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D019072:Antibiotic Prophylaxis; D001707:Biopsy, Needle / Q000379:methods; D005578:Fosfomycin / Q000008:administration & dosage*; D006801:Humans; D061705:Image-Guided Biopsy; D064704:Levofloxacin; D008297:Male; D008875:Middle Aged; D015242:Ofloxacin / Q000008:administration & dosage*; D011467:Prostate / Q000000981:diagnostic imaging* / Q000473:pathology*; D012189:Retrospective Studies; D018084:Ultrasonography, Interventional
chemical_list: D000900:Anti-Bacterial Agents; D005578:Fosfomycin; D064704:Levofloxacin; D015242:Ofloxacin