Abstract

Objective: The aim of this study was to compare the efficacy of single-dose 500 mg oral levofloxacin administration and five-day oral ciprofloxacin regimen in preventing infectious complications following transrectal prostate biopsy.

Materials and methods: The study included 142 patients (mean age 65±8 years; range 43 to 82 years) undergoing 12-core transrectal prostate biopsy. In 72 patients, a single-dose 500 mg levofloxacin was given orally 30-60 minutes before the procedure, while 70 patients received five-day, 500 mg oral ciprofloxacin given twice daily starting one day before the procedure. Urine samples were obtained for urine microscopy and culture just before the procedure and after the last dose of ciprofloxacin. The two groups were compared with respect to findings of urine microscopy and culture before and after the procedure, and complications. 

Results: There were no significant differences between the two groups with respect to age, PSA level, prostate volume, findings of urine microscopy and culture before and after the procedure, and the incidence of fever after the procedure (p>0.05). In the levofloxacin and ciprofloxacin groups, five (6.9%) and three (4.3%) patients had positive urine cultures before the procedure, and the incidences of new culture-positivity were 3% (n=2) and 6% (n=4) after the procedure, respectively. The most commonly isolated bacteria was Escherichia coli. Within-group comparisons of urine microscopy and culture showed no significant differences for both groups (p>0.05). None of the patients developed sepsis or severe procedure-related complications.

Conclusion: Both single-dose levofloxacin and five-day ciprofloxacin regimens seem to be equally effective in the antibiotic prophylaxis for transrectal prostate biopsy, but levofloxacin offers the advantage of single-dose usage.