Bacterial prostatitis

Wagenlehner, Florian M. E.; Pilatz, Adrian; Bschleipfer, Thomas; Diemer, Thorsten; Linn, Thomas; Meinhardt, Andreas; Schagdarsurengin, Undraga; Dansranjavin, Temuujin; Schuppe, Hans‐Christian; Weidner, W.

doi:10.1007/s00345-013-1055-x

Cited by 49 publications

(48 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Lastly, prostatic calcifications were present in 4/7 (57%) patients with microbiological failure. CBP is now considered a biofilm infection (18)(19)(20)(21), and bacteria present in calcification biofilms are difficult to eradicate, potentially leading to therapeutic failure.…”

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

View full text Add to dashboard Cite

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 ...

show abstract

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

View full text Add to dashboard Cite

show abstract

“…Several review articles on the subject [1,2,3] do not give any recommendation on this particular situation and a literature search does not reveal reliable suggestions. Some colleagues perform ‘radical' TURP with removal of as much prostatic tissue as possible (personal communication).…”

Section: Discussionmentioning

confidence: 99%

“…This condition generally is treated with antibiotics [1,2,3]. However, if this has to be restarted several times, progressive bacterial resistance often develops, making treatment problematic.…”

Section: Introductionmentioning

confidence: 99%

Transurethral Resection of the Prostate in Recurrent Acute Bacterial Prostatitis

Decaestecker

Oosterlinck²

2014

Urol Int

View full text Add to dashboard Cite

Objective: To explore the outcome of transurethral resection of the prostate (TURP) in the treatment of refractory recurrent acute bacterial prostatitis. Patients and Methods: From 2004 to 2013, 23 TURP for this indication were performed in 21 patients; two patients underwent it twice. The files of these patients were retrospectively analysed for outcome and side effects. TURP intended to remove as much infected tissue as possible under appropriate antibiotherapy. Results: Twelve patients became free of symptoms during a follow-up of 3-108 months (median 44), two others became disease-free after one and two postoperative attacks, respectively; eight were not cured and had rapid recurrences; three patients had follow-up of a few weeks only. Two failures developed orchiepididymitis shortly after the procedure and one a year later. No incontinence or bladder neck contracture was noted. Conclusion: TURP is an acceptable procedure in the treatment of refractory recurrent bacterial prostatitis. It could cure about two thirds of patients.

show abstract

“…The diagnosis is usually suggested by a microscopic analysis of a midstream urine specimen and confi rmed by a mandatory microbiological culture which is the only laboratory examination required [ 1 ]. If the clinical signs suggest a systemic or even accompanying bloodstream infection, a blood culture is suggested [ 1 , 10 ].…”

Section: Laboratory Analysismentioning

confidence: 99%

The Diagnostic Approach to Patients with Prostatitis-Like Symptoms: What Do We Have to Do?

Benelli

Wagenlehner

2016

Prostatitis and Its Management

Self Cite

View full text Add to dashboard Cite

Bacterial prostatitis

Abstract: Bacterial prostatitis has developed into well-managed entities with increasing antimicrobial resistance being the most severe drawback of yielding therapeutic success.

Cited by 49 publications

References 32 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

Transurethral Resection of the Prostate in Recurrent Acute Bacterial Prostatitis

The Diagnostic Approach to Patients with Prostatitis-Like Symptoms: What Do We Have to Do?

Contact Info

Product

Resources

About