Comparative Randomized Pilot Study of Azithromycin and Doxycycline Efficacy and Tolerability in the Treatment of Prostate Infection Caused by <i>Ureaplasma urealyticum</i>

Abstract

A total of 1,442 patients with symptoms of chronic prostatitis were examined over a 4-year period at the Outpatient Department for Urogenital Infections, University Hospital for Infectious Diseases Dr. Fran Mihaljević, Zagreb, Croatia. The inclusion criteria for chronic prostatitis caused by Ureaplasma urealyticum were the presence of clinical symptoms, presence of U. urealyticum in expressed prostatic secretion (EPS) or voided urine collected immediately after prostatic massage (VB₃), absence of U. urealyticum in urethral swabs and absence of other possible pathogens of chronic prostatitis in EPS or VB₃. A total of 63 patients with prostate infection caused by U. urealyticum were available for this pilot study. The patients were randomized according to a computer randomization list to receive a total dose of 4.5 g of azithromycin given as a 3-day therapy of 1 × 500 mg weekly for 3 weeks or doxycyline 100 mg b.i.d. for 21 days. Patients’ sexual partners were treated at the same time. Clinical efficacy and tolerability of the administered drug as well as possible adverse events were evaluated during, at the end and 4–6 weeks after completion of therapy. Bacteriological efficacy was evaluated 4–6 weeks after completion of therapy. Treatment groups did not differ regarding age, distribution of urethral, prostatic, sexual and other symptoms, or digitorectal prostatic examination. Five patients treated with doxycycline had nausea. In the group of patients with prostate infection caused by U. urealyticum, the eradication rate was not significantly different with regard to the administered azithromycin (25/32) or doxycycline (23/31). Clinical cure did not significantly differ with regard to the administered azithromycin (22/32) or doxycycline (21/31).

Efficacy of standard therapies againstUreaplasmaspecies and persistence among men with non-gonococcal urethritis enrolled in a randomised controlled trial

“…However, our findings are similar to a more recent trial of men with prostatitis attributed to undifferentiated Ureaplasma, with rates of persistent detection of 22% and 26%, respectively. 18 Consistent with both previous studies, we found little difference in the efficacy of the two therapies for UU-2, suggesting that either treatment is an appropriate first-line regimen for men with UU-2-associated NGU. However, among men with UP, persistent detection was somewhat more common among men who received azithromycin compared with those that received doxycycline.…”

Macrolides for the treatment of chronic bacterial prostatitis: An effective application of their unique pharmacokinetic and pharmacodynamic profile (Review)

“…The eradication rates for azithromycin and clarithromycin were high and similar: 80 (75). Similar results were obtained in CBP caused by U. urealyticum (76).…”

Atypical infections of the prostate

“…The inclusion criteria for chronic prostatitis caused by U. urealyticum were the presence of clinical symptoms, presence of U. urealyticum in EPS, or voided urine collected immediately after prostatic massage. In the group of patients with prostate infection caused by U. urealyticum, the eradication rate was not significantly different when treated with azithromycin (25 of 32 patients) or doxycycline (23 of 31 patients) [23].…”