A 64-year-old man took levofloxacin 100 mg three times a day from the day before trans-rectal prostate needle biopsy. He suddenly fell into septic shock about 12 hours after the biopsy. We performed polymyxin B-immobilized fiber-direct hemoperfusion treatment at our intensive care unit. The circle dynamics was stable after five days of observation, and he was discharged seven days after the event. Levofloxacin-resistant Escherichia coli (E. coli) was detected by blood and urine culture.