Single-Dose versus Multiple-Dose Ciprofloxacin plus Metronidazole Prophylaxis in Transrectal Ultrasound-Guided Biopsy of the Prostate: a Randomized Controlled Trial

To investigate and compare the infectious and non-infectious complications of single-dose versus multiple-dose antibiotic therapy for trans-rectal ultrasound (trus)-guided biopsy of the prostate. patients were enrolled in a prospective randomized study that was designed to investigate the effects of single-dose versus multiple-dose antimicrobial prophylaxis regimen mainly on asymptomatic bacteriuria, urinary tract infection (uti) without fever, fever and urinary septicemia. the single-dose group received one ciprofloxacin 500 mg tablet and two metronidazole 250 mg tablets at 2 hours before the biopsy, while the multiple-doses group received those every 12 hours from 3 days before the biopsy. one-hundred and sixty patients were evaluated in two groups and bacteriuria in urinalysis was encountered in 12 patients (15%) in the single-dose group and four patients (5%) in the multiple-dose group, with a significant difference (p=0.035). uti without fever occurred in six patients (7.5%) in the single-dose group and one patient (1.25%) in the multiple-dose group, with no significant difference (borderline p=0.053). after biopsy, three patients (3.75%) returned with fever due to uti and bacteremia in the single-dose group and none in the multiple-dose group, but with no significant difference (p=0.08). regarding non-infectious complications, there were no significant differences between the two groups. using prophylactic antibiotics for prostate biopsy in multiple doses, and at least 3 days before the procedure significantly reduces the rate of bacteriuria compared with a single-dose regimen.