Comparative randomized pilot study of azithromycin and doxycycline efficacy in the treatment of prostate infection caused by Chlamydia trachomatis

Škerk, Višnja; Krhen, Ivan; Lisić, Miroslav; Begovać, Josip; Roglić, Srđan; Škerk, Vedrana; Sternak, Sunčanica Ljubin; Banaszak, Artur; Strugar-Šuica, Jadranka; Vuković, Jacinta

doi:10.1016/j.ijantimicag.2004.03.014

Cited by 28 publications

(15 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A total of 91 per-protocol patients were randomi zed to receive a total of 4.5 g of azithromycin (500 mg once daily for 3 consecutive days each week) for 3 weeks, or 500 mg clarithromycin twice daily. The eradication rates for azithromycin and clarithromycin were high and similar: 80 (75). Similar results were obtained in CBP caused by U. urealyticum (76).…”

Section: Clinical Evidence Of Efficacy Of Macrolides In Prostate Infesupporting

confidence: 73%

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

et al. 2011

View full text Add to dashboard Cite

Abstract. Chronic bacterial prostatitis (CBP) is a persistent infection of the prostate characterized by poor quality of life mainly due to frequent relapse episodes caused by incomplete eradication of causative pathogens. Aggressive antibacterial therapy is required to attenuate the severe symptoms of CBP and to achieve a permanent cure. Although fluoroquinolones are currently recommended as first-choice agents, macrolide antibiotics are emerging as a noteworthy option for the treatment of CBP. Macrolide antibiotics are characteri zed by an impressive array of distinct pharmacokinetic (PK) and pharmacodynamic (PD) properties. These properties include high intracellular accumulation in phagocytes and at sites of infection, including the prostate; broad antibiotic but also biofilm-inhibiting properties; immunomodulating and inflammation-resolving activities. These features offer particular advantages for the treatment of chronic infections of the prostate gland, which are not easily amenable to drug therapy. Macrolides may be exploited to counteract the unsatisfactory rates of clinical symptom improvement and pathogen eradication. The results of a number of clinical trials support this proposal.

show abstract

Section: Clinical Evidence Of Efficacy Of Macrolides In Prostate Infesupporting

confidence: 73%

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

et al. 2011

View full text Add to dashboard Cite

show abstract

“…Since 1999 to date, we conducted 6 randomized studies, including this one, on the effi cacy and tolerability of various treatment schemes of chronic prostatitis in which azithromycin was administered as intermittent (pulse) therapy [8][9][10][11][12] . A search of the literature showed that no similar studies have been published so far.…”

Section: Discussionmentioning

confidence: 99%

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

Škerk

Mareković²,

Markovinović

et al. 2005

Chemotherapy

Self Cite

View full text Add to dashboard Cite

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).

show abstract

“…Possible reasons include the short treatment duration (≤12 weeks) and/or inclusion of refractory patients with previous exposure to a-blockers [57] Antibiotics CBP Despite the widespread use of antibiotics in patients with CBP and CP/CPPS, evidence in a CBP population primarily exists within RCTs or retrospective comparative trials lacking placebo control. Microbiological eradication rates were 40-77% for ciprofloxacin [65][66][67], 75% for levofloxacin [65], 80% for azithromycin [66,68,69], 77% for doxycycline [68], 80% for clarithromycin [69], and 62-77% for azithromycin + ciprofloxacin (depending on ciprofloxacin dose) [70]. Higher eradication rates (>90%) were reported with azithromycin and levofloxacin either alone, in combination or sequentially, depending on the locality of infection (urethral, prostatic or both) in patients with CBP with C. trachomatis infection [71].…”

Section: A-adrenergic Antagonistsmentioning

confidence: 99%

“…Significant differences in symptom severity, as assessed by changes in NIH-CPSI scores, were seen between baseline and the end of treatment in two trials [70,71]. Others reported improvements in clinical outcomes but failed to use validated tools to report these [65][66][67][68][69] Of the identified comparative studies in patients with CBP, one (n = 408) found that levofloxacin offered advantages over ciprofloxacin for bacterial eradication rates and clinical improvement [67], while another of similar size (n = 377) and design showed no significant differences between these agents [65]. Azithromycin was reported to be more effective than ciprofloxacin in the treatment of C. trachomatis infections [66].…”

Section: A-adrenergic Antagonistsmentioning

confidence: 99%

Diagnosis and treatment of chronic bacterial prostatitis and chronic prostatitis/chronic pelvic pain syndrome: a consensus guideline

Rees

Abrahams

Doble³

et al. 2015

BJU International

241

193

View full text Add to dashboard Cite

ObjectivesTo improve awareness and recognition of chronic bacterial prostatitis (CBP) and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) among non-specialists and patients. To provide guidance to healthcare professionals treating patients with CBP and CP/CPPS, in both non-specialist and specialist settings. To promote efficient referral of care between nonspecialists and specialists and the involvement of the multidisciplinary team (MDT). Patients and MethodsThe guideline population were men with CBP or CP/CPPS (persistent or recurrent symptoms and no other urogenital pathology for ≥3 of the previous 6 months). Consensus recommendations for the guidelines were based on a search to identify literature on the diagnosis and management of CBP and CP/CPPS (published between 1999 and February 2014). A Delphi panel process was used where high-quality, published evidence was lacking. ResultsCBP and CP/CPPS can present with a wide range of clinical manifestations. The four main symptom domains are urogenital pain, lower urinary tract symptoms (LUTSvoiding or storage symptoms), psychological issues and sexual dysfunction. Patients should be managed according to their individual symptom pattern. Options for first-line treatment include antibiotics, a-adrenergic antagonists (if voiding LUTS are present) and simple analgesics. Repeated use of antibiotics, such as quinolones, should be avoided if there is no obvious symptomatic benefit from infection control or cultures do not support an infectious cause. Early use of treatments targeting neuropathic pain and/or referral to specialist services should be considered for patients who do not respond to initial measures. An MDT approach (urologists, pain specialists, nurse specialists, specialist physiotherapists, general practitioners, cognitive behavioural therapists/psychologists, and sexual health specialists) is recommended. Patients should be fully informed about the possible underlying causes and treatment options, including an explanation of the chronic pain cycle. ConclusionChronic prostatitis can present with a wide variety of signs and symptoms. Identification of individual symptom patterns and a symptom-based treatment approach are recommended. Further research is required to evaluate management options for CBP and CP/CPPS.

show abstract

Comparative randomized pilot study of azithromycin and doxycycline efficacy in the treatment of prostate infection caused by Chlamydia trachomatis

Cited by 28 publications

References 8 publications

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

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

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

Diagnosis and treatment of chronic bacterial prostatitis and chronic prostatitis/chronic pelvic pain syndrome: a consensus guideline

Contact Info

Product

Resources

About