Semen and urine culture in the diagnosis of chronic bacterial prostatitis

Montes, Luis Zegarra; Mejia, Alan; Munarriz, Cesar Antonio Loza; Gutierrez, Eric

doi:10.1590/s1677-55382008000100006

Cited by 30 publications

(15 citation statements)

References 30 publications

(9 reference statements)

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“…Furthermore, clinical response evaluations are subjective, and the Meares-Stamey test (four-glass test), which is considered the diagnostic reference standard, was not systematically employed, as it is a cumbersome method that is used little in clinical settings (24). Semen culture used in our study has a sensitivity similar to that of the four-glass method (25), and because of its high specificity (94%), some authors consider it sufficient for initiating antibiotics in symptomatic patients (26). We believe it is unlikely that the microbiological relapse rate in our study would have been higher if the 4-glass test had been used, as our patients had a lengthy clinical follow-up period (Ͼ1 year).…”

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confidence: 99%

Long-Term Fosfomycin-Tromethamine Oral Therapy for Difficult-To-Treat Chronic Bacterial Prostatitis

Los‐Arcos

Pigrau

Rodríguez-Pardo

et al. 2016

Antimicrob Agents Chemother

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This is a retrospective study of 15 difficult-to-treat (i.e., exhibiting previous failure, patient side effects, or resistance to ciprofloxacin and co-trimoxazole) chronic bacterial prostatitis infections (5 patients with multidrug-resistant Enterobacteriaceae [MDRE]) receiving fosfomycin-tromethamine at a dose of 3 g per 48 to 72 h for 6 weeks. After a median follow-up of 20 months, 7 patients (47%) had a clinical response, and 8 patients (53%) had persistent microbiological eradication; 4/5 patients with MDRE isolates achieved eradication. There were no side effects. Fosfomycin-tromethamine is a possible alternative therapy for chronic bacterial prostatitis. Chronic bacterial prostatitis (CBP) is a troublesome disease, showing an overall clinical and microbiological response rate to fluoroquinolones, the antibiotics of choice, of only 60% (1-4). In CBP caused by Escherichia coli, the reported resistance rates are 11% to ciprofloxacin and 20% to norfloxacin (5). Co-trimoxazole is an alternative antibiotic option, but its cure rates are lower than those of other drugs (1, 4). The resistance rate to co-trimoxazole is high in patients with urinary tract infections (UTI) (around 34% in Spain) (6), and reported resistance in E. coli CBP is 24% (5). Other antibiotics are usually ineffective due to poor prostatic penetration; hence, there may be no effective antibiotic therapy for some patients (1).Fosfomycin-tromethamine (FT) has broad-spectrum antimicrobial activity and is useful for treating lower UTI caused by extended-spectrum ␤-lactamase (ESBL)-producing Enterobacteriaceae (7-10). Mean fosfomycin levels in the uninflamed peripheral prostate region after 3 g of FT were found to be Ͼ4 g/g of tissue in 70% of patients (11). This value is higher than the MIC breakpoint of many uropathogens. In addition, FT proved useful in 2 cases of multidrug-resistant Enterobacteriaceae (MDRE) prostatitis (12 In this retrospective study, we assessed the efficacy of FT as an alternative therapy for patients with difficult-to-treat CBP. The inclusion criteria were a diagnosis of CBP, failure of prolonged antibiotic therapy, and no possibility of fluoroquinolone or cotrimoxazole use due to resistance, failure, or side effects (Fig. 1). All patients had been treated and followed up in our UTI outpatient clinic (January 2010 to July 2014) by one of the authors (C.P.). The study was approved by the hospital ethics committee and Spanish Drug Agency (approval VDH-FOS-2014-01).A diagnosis of CBP was established when all 4 criteria were met: (i) history of CBP, defined as Ն1 previous symptomatic episode of bacterial prostatitis of Ն4 weeks duration or Ն2 episodes of any duration in the preceding 12 months; (ii) current symptoms of prostatitis; (iii) absence of genitourinary abnormalities on Ն1 urologic ultrasound assessment; and (iv) current laboratory evidence of infection, including positive Meares-Stamey test result (14), positive semen culture, or Ն2 positive urine cultures with the same microorganism performed Ն1 month apart, in which ...

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mentioning

confidence: 99%

Long-Term Fosfomycin-Tromethamine Oral Therapy for Difficult-To-Treat Chronic Bacterial Prostatitis

Los‐Arcos

Pigrau

Rodríguez-Pardo

et al. 2016

Antimicrob Agents Chemother

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“…Diary cards and questionnaires were also used for patients to monitor the benefit or adverse effects arising from the studies. These are valid methods for qualitative and quantitative analysis (Devillé et al, 2004;Gill et al, 2003;Savarinoa et al, 1999;Zegarra et al, 2008).…”

Section: Discussionmentioning

confidence: 99%

“…The experimental approaches used were found to be suitable for analysing biomarkers, or symptoms associated with treating infectious diseases (Devillé et al, 2004;Gill et al, 2003;Savarinoa et al, 1999;Zegarra et al, 2008), therefore benefit claims of PFS can be made for treating symptoms of the infectious diseases. The patient sample size and the overall quality of the study design appeared to play a bigger role in influencing the outcome of the trials.…”

Section: Discussionmentioning

confidence: 99%

A review of the Experimental Approaches Used in Clinical Studies to Evaluate the Health Benefits of Plant Food Supplements Associated With Infectious Diseases

Naidoo¹,

Mancama²,

Meoni³

et al. 2015

JFR

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The objective of this review was to evaluate the experimental approaches used in clinical trials to support the benefit claims of plant food supplements (PFS) with reported activity on infectious diseases. A literature search was conducted on a list of 309 plant species currently used in food supplements in Europe using the National Centre for Biotechnology Information (NCBI) PubMed Database to identify all the clinical trials for evaluating the benefit claim for preventing or treating infectious diseases in humans. The searches included a combination of terms related to the name of plants, class of infectious agents and therapeutic activities against infectious disease. By limiting the searches to clinical studies, only 27 articles representing 19 plant species were identified. From this list, 13 papers from the 10 plants most extensively researched were critically evaluated for assessing methods used to assess the benefits of PFS. Different study designs were used ranging from an open trial with no placebo or control and no randomization to double-blind randomized placebo controlled trials including a crossover design. Although the experimental approaches described in this review were found to be suitable for evaluating the benefit claims of PFS for treating infectious diseases caused by bacteria, viruses, fungi and parasites, the clinical study design should be more standardised as many studies lacked a control group and sufficient population size to be statistically acceptable taking into consideration patient variability. The reporting of the results varied and should also be standardised to include all the study parameters and data collected.

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“…Microbiological examination: Culturing of prostatic secretion, urine, and semen can facilitate the diagnosis of prostatic infection (49,52). …”

Section: Clinical Diagnosis Of Ejaculatory Disorders (Ejds)mentioning

confidence: 99%

The office management of ejaculatory disorders

Jiann

2016

Transl. Androl. Urol.

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Premature ejaculation (PE), delayed ejaculation (DE), anejaculation (AE) and retrograde ejaculation (RE) are four main ejaculatory disorders (EjDs) observed in clinical practice. Despite their high prevalence, EjDs remain underdiagnosed and undertreated. Primary care physicians should incorporate the discussion of sexual health topics into routine visits to facilitate EjD diagnosis and treatment. Because the causes of EjDs are multifactorial, the management of EjDs is etiology-specific and may require a holistic approach. Dapoxetine, a selective serotonin reuptake inhibitor, is the only drug approved for on-demand treatment of lifelong and acquired PE. In clinical practice, scheduled follow-up visits, risk factor treatment, appropriate dose escalation, adequate sexual attempts, patient education, and partner involvement are critical factors responsible for optimal overall management of PE and dapoxetine treatment outcomes.

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Semen and urine culture in the diagnosis of chronic bacterial prostatitis

Cited by 30 publications

References 30 publications

Long-Term Fosfomycin-Tromethamine Oral Therapy for Difficult-To-Treat Chronic Bacterial Prostatitis

Long-Term Fosfomycin-Tromethamine Oral Therapy for Difficult-To-Treat Chronic Bacterial Prostatitis

A review of the Experimental Approaches Used in Clinical Studies to Evaluate the Health Benefits of Plant Food Supplements Associated With Infectious Diseases

The office management of ejaculatory disorders

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