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KMID : 1011820220630030325
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Investigative and Clinical Urology
2022 Volume.63 No. 3 p.325 ~ p.333
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Antibiotic therapy of chronic bacterial prostatitis is more effective considering antibiotic susceptibility of all pathogens isolated
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Kogan Mikhail I.
Ibishev Khalid S.
Naboka Yulia L.
Gudima Irina A.
Ferzauli Akhmed Kh.
Ismailov Ruslan S.
Naber Kurt G.
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Abstract
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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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KEYWORD
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Anti-bacterial agents, Bacterial load, Bacteriological techniques, Drug resistance, bacterial, Prostatitis
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