Abstract Objective: In order to evaluate the prevalence and clinical risk factors for quinolone resistance (QR) in E. coli strains from males with febrile urinary tract infection (FUTI). Methods: We diagnosed that patients by clinical manifestations and urinary bacterial smears in 123 males with a community FUTI caused by E. coli, and collected clean-catch midstream urine or urine samples from bladder puncture for bacterial culture and sensitivity test of urine. We Observed the response of E. coli resistance to various antibiotics, and evaluated the clinical risk factors for quinolone resistance (QR) in E. coli. Results: Among the 123 FUTI episodes, 34% of E. coli strains resistant to quinolones, and it also higher frequency resistance to other antibiotics. In the univariate analysis QR was associated with older age, past UTI, urinary tract abnormalities, previous antibiotic use, particularly with fluoroquinolones (FQ), a healthcare-associated-UTI (HA-UTI). In the multivariate analysis, HA-UTI (OR 4.34, 95% Cl 1.62-12.13, P＜0.001) and use of antimicrobials in the previous month, mainly with FQ (OR 14.37, 95% Cl 2.14-73.26, P＜0.001) were risk factors for QR E. coli. Conclusion: To have a HA-UTI and a previous use of FQ in the preceding month were strong risk factors for QR E. coli, and thus empirical antimicrobial treatment with quinolones should be avoided in these patients.