title: The use of prophylactic single-dose fosfomycin in patients who undergo transrectal ultrasound-guided prostate biopsy: A prospective, randomized, and controlled clinical study.
abstract: BACKGROUND
  We aimed to demonstrate the efficacy, safety, and convenient use of fosfomycin trometamol in the preoperative antibiotic prophylaxis (PAP) of transrectal ultrasound-guided biopsy of the prostate (TRUSBP) in this prospective, randomized study.
  
  
  METHODS
  Between May 2014 and May 2015, a total of 300 patients who underwent TRUSBP were examined prospectively. Patients were randomized into two groups: group 1 consisted of 150 patients who were administered a single dose of 3 g oral fosfomycin as a PAP the night before the procedure; group 2 consisted of 150 patients who were administered 500 mg oral ciprofloxacin 60 min before the procedure as a PAP. Post-procedural febrile and afebrile infectious complications and pathological characteristics of the two groups were compared prospectively.
  
  
  RESULTS
  The mean age of the patients was 63.5±0.6 years in group 1 and 62.9±0.6 years in group 2. A total of two patients (1.3%) in group 1 and nine patients (6.0%) in group 2 experienced afebrile urinary tract infection (UTI). Afebrile UTI rate was significantly higher in group 2 (1.3% s. 6.0%, p=0,032). Febrile UTI was detected in two patients in group 2 and one patient in group 1. Urine cultures revealed 35.7% fluoroquinolone resistance. As a limitation, although the sample size was appropriate due to the power calculation, we believe that comprehensive studies including larger patient cohorts are needed to support our findings.
  
  
  CONCLUSIONS
  Due to its ease-of-use with only a single dose and lower rates of infectious complications (resistant and febrile UTIs), fosfomycin trometamol is a strong alternative for antibiotic prophylaxis in TRUSBP.
authors.affiliation: Izmir Bozyaka Training and Research Hospital Department of Urology, Izmir, Turkey;
authors.forename: Volkan
authors.initials: V
authors.lastname: Sen
authors.affiliation: Izmir Bozyaka Training and Research Hospital Department of Urology, Izmir, Turkey;
authors.forename: Ozgu
authors.initials: O
authors.lastname: Aydogdu
authors.affiliation: Izmir Bozyaka Training and Research Hospital Department of Urology, Izmir, Turkey;
authors.forename: Ibrahim Halil
authors.initials: IH
authors.lastname: Bozkurt
authors.affiliation: Izmir Bozyaka Training and Research Hospital Department of Urology, Izmir, Turkey;
authors.forename: Tarik
authors.initials: T
authors.lastname: Yonguc
authors.affiliation: Izmir Katip Celebi University Ataturk Training and Research Hospital Department of Infectious Diseases and Clinical Microbiology, Izmir, Turkey.
authors.forename: Pinar
authors.initials: P
authors.lastname: Sen
authors.affiliation: Izmir Bozyaka Training and Research Hospital Department of Urology, Izmir, Turkey;
authors.forename: Salih
authors.initials: S
authors.lastname: Polat
authors.affiliation: Izmir Bozyaka Training and Research Hospital Department of Urology, Izmir, Turkey;
authors.forename: Tansu
authors.initials: T
authors.lastname: Degirmenci
authors.affiliation: Izmir Bozyaka Training and Research Hospital Department of Urology, Izmir, Turkey;
authors.forename: Deniz
authors.initials: D
authors.lastname: Bolat