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Fluoroquinolone-resistant acute prostatitis requiring hospitalization after transrectal prostate biopsy: effect of previous fluoroquinolone use as prophylaxis or long-term treatment

  • Urology – Original Paper
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Abstract

Objectives

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.

Patients and 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.

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Acknowledgments

We would like to thank Associate Professor Doctor Aynur Topkaya, Department of Microbiology, Maltepe University School of Medicine, for providing the methods used routinely in the microbiology laboratory.

Ethical approval

The data base and evaluation of results were approved by the ethics committee of Maltepe University (MLT.ÜNİ.GOKADK 2010/3).

Conflict of interest

No competing financial interests exist.

Author information

Authors and Affiliations

  1. Department of Urology, Maltepe University School of Medicine, Feyzullah Caddesi, No: 39, 34843, Istanbul, Turkey

    Sinan Ekici & Güven Turan

  2. Department of Infectious Diseases, Maltepe University School of Medicine, Istanbul, Turkey

    Melahat Cengiz & Esra Ergün Alış

Authors
  1. Sinan Ekici
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  2. Melahat Cengiz
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  3. Güven Turan
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  4. Esra Ergün Alış
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Correspondence to Sinan Ekici.

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Ekici, S., Cengiz, M., Turan, G. et al. Fluoroquinolone-resistant acute prostatitis requiring hospitalization after transrectal prostate biopsy: effect of previous fluoroquinolone use as prophylaxis or long-term treatment. Int Urol Nephrol 44, 19–27 (2012). https://doi.org/10.1007/s11255-011-9980-3

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  • DOI: https://doi.org/10.1007/s11255-011-9980-3

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