Kogan MI, Ibishev KS, Naboka YL, Gudima IA, Ferzauli AK, Ismailov RS, Naber KG. Antibiotic therapy of chronic bacterial prostatitis is more effective considering antibiotic susceptibility of all pathogens isolated.
Investig Clin Urol 2022;
63:325-333. [PMID:
35437957 PMCID:
PMC9091822 DOI:
10.4111/icu.20210451]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 12/14/2021] [Accepted: 01/19/2022] [Indexed: 11/26/2022] Open
Abstract
Purpose
Because of the insufficient efficacy of the current treatment of chronic bacterial prostatitis (CBP), it is justified to search for a more effective antibiotic therapy (ABT).
Materials and Methods
This single-centre prospective observational comparative study was conducted in 2012 to 2019 (patients: 60 men with CBP; age: 20–45 y). The clinical examination was performed on admission and at 1, 3, 6, or 12 months. All patients underwent the Meares–Stamey test to obtain expressed prostatic secretion (EPS) and/or post-massage urine (PMU) samples for extended bacteriological examination. The patients were randomly divided into 2 treatment groups (30/30 patients): group I, fluoroquinolones (FQs); group II, a combination of FQs with cephalosporins/macrolides with a treatment duration of 1 month.
Results
Patients of both groups had severe symptomatic CBP with an average duration of 4 years. Twenty-three microorganisms (15 aerobes, 9 anaerobes) were identified in PMU. At 3 months follow-up, a positive clinical effect was noted in both groups, which was significant (p<0.05) only in group II concerning NIH-CPSI questionnaire, leukocyturia, prostate volume, maximum urine flow, and decreased pathospermia. At 6 months follow-up, in group II the frequency of Escherichia coli and Enterococcus spp. decreased significantly. In group I aerobes changed only insignificantly from the initial level, but anaerobes increased significantly. In group II the titers of both, aerobes and anaerobes, were significantly lower (p<0.05) at 6 months follow-up as compared to initial values.
Conclusions
ABT targeting all taxa in EPS/PMU is a more effective alternative to standard therapeutic regimens for CBP.
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