Efficacy and safety of prophylactic single-dose levofloxacin 500 mg for transrectal prostate needle biopsy in Japanese patients: A case control study

The Japanese guidelines for the prevention of perioperative infection in urology were published by the Japanese Urological Association in 2007. According to these guidelines, the first choice for prophylaxis to prevent perioperative infection following prostate needle biopsy is the administration of a high dosage of oral fluoroquinolones for 1 day for low - risk patients (e. g. levofloxacin [LVFX] 200 mg t.i.d. (600 mg/day)). Subsequently the LVFX 500 mg tablet became available in Japan in June 2009 in place of the 100 mg tablet, and accordingly we prospectively evaluated the effectiveness and safety of a single dose of levofloxacin (LVFX) 500 mg as prophylaxis for patients who undergo transrectal ultrasonography-guided prostate needle biopsy. Between January 2010 and February 2011, a single oral dose of LVFX was administered several hours before the P-biopsy. Informed consent was obtained from all patients. They were given a questionnaire about the symptoms of complications prior to discharge. Questionnaires were collected at their first clinical visit. Complications and perioperative infections were analyzed. One hundred and thirty-four patients were enrolled and 100 patients completed the study. There were no complications from LVFX, and only 1 patient developed acute prostatitis and sepsis following P-biopsy. The low incidence of prostatitis in this study suggests that preoperative single-dose LVFX is effective and safe when compared with the previously recommended prophylaxis.