Antibiotic prophylaxis in prostate biopsy: a comparative randomized clinical assay between ciprofloxacin, norfloxacin and chloramphenicol

OBJECTIVE: To compare, prospectively, 4 different schemes of antibiotic prophylaxis previously to transrectal prostate biopsy. MATERIALS AND METHODS: 257 patients were randomized in 4 groups: Group I: single dose of ciprofloxacin 2 hours before the procedure; Group II: ciprofloxacin 3 days; Group III: chloramphenicol 3 days; and Group IV: norfloxacin 3 days. The complication rate was assessed in a blind way on the third and on the thirtieth days through a questionnaire. Groups were compared by the qui-square method and, in small samples, by the Fisher method, with statistical significance of 95%. RESULTS: Complications index throughout the sample differed between the 4 groups of patients under study, being 3.1% for group I, 2.1% for group II, 18.3% for group III and 10.5% for group IV. Schemes employing ciprofloxacin were statistically superior to those that used norfloxacin or chloramphenicol (p < 0.05). There was no difference between a single dose and 3 days of ciprofloxacin (p > 0.05). CONCLUSION: Schemes using ciprofloxacin presented better results in prophylaxis previously to prostate biopsy. We recommend using a single dose of ciprofloxacin due to its posologic ease and low cost, associated with a therapeutic response equivalent to 3-day regimens