Post-biopsy infection and sepsis rates are significantly higher in groups of patients given empirical fluoroquinolone prophylaxis when compared to those who receive antimicrobial therapy. These are the results of a review paper titled “The role of targeted prophylactic antimicrobial therapy before transrectal ultrasonography-guided prostate biopsy in reducing infection rates: a systematic review,” published in BJU International, that evaluated the current recommendations for antimicrobial prophylaxis (prevention of disease) to reduce the risk of post-TRUS biopsy infective complications (PTBICs). Transrectal ultrasonography (TRUS)-guided biopsy is currently the standard method used to obtain tissue samples for histological diagnosis of prostate cancer. However, the biopsy technique is associated with several health risks, such as pain, urinary retention, and, most importantly, infection, which can range from UTI (urinary tract infection) to severe sepsis. Such post-TRUS biopsy infective complications (PTBICs) are an important and costly issue. Routine prevention of infections relies on the use of fluoroquinolone antibiotics, which tend to reach high concentrations in the prostate after oral administration. However, PTBICs are increasingly linked with fluoroquinolone resistant (FQ-R) E. coli, a pathogen that is present in 75 to 90 percent of PTBICs cases. In light of these facts, researchers theorized that the recommendations for infection prevention that are currently implemented might need to be reviewed. One such approach is pre-biopsy screening for FQ-R, which allows the physician to tailor the antimicrobial prophylaxis to each individual patient. However, there is still not enough data that cements the recommendation of pre-biopsy screening programs.