AbstractAim: To study the spectrum of organisms and their antibiotic sensitivity studied from rectal swabs in the community. Methods: A 2 years prospective study in which rectal swabs were collected from patients who fulfilled the inclusion criteria. Baseline information with a detailed written informed consent was taken from each patient. Results were characterized for identification of the organisms and antimicrobial susceptibilities. The data was tabulated for evaluation on a predesigned proforma. Results: Of 373 patients, 290 patients were male and 83 female (Mean age - 62.7 +/- 18 years). The most common organism was Escherichia coli in 76.56% of cases, Klebsiella Sp in 12.5%, Proteus Sp in 1.56% and others including Enterococcus, Pseudomonas, Staphylococcus aureus contributed to 9.37%. In the antibiotic sensitivity pattern, the sensitivity of fluoroquinolones was as low as 48.43%. Nitrofurantoin showed a higher sensitivity of 83.59 % than fluoroquinolones but similar to carbapenems (88.2%) and third generation cephalosporins (78.12%). In our study, 23 patients were planned for a TRUS guided prostate biopsy. The culture positive rate in this group was 43.47 % of which 60% of the organisms grown was Esherichia coli (p = 0.01) on sub group analysis. They showed a quinolone sensitivity of only 40% . Conclusion: With increasing antibiotic resistance and multi drug resistant organisms, we suggest the use of a culture based antibiotic for infections and trans rectal biopsy procedures. There is a change in antibiotic resistance pattern of organisms of the gut flora with rising pattern of fluoroquinolone resistance. Keywords: Antibiotic sensitivity; Biopsy; E-Coli; Prostate biopsy; Rectal swab.