Efficacy of repeated cycles of combination therapy for the eradication of infecting organisms in chronic bacterial prostatitis

Magri, Vittorio; Trinchieri, Alberto; Pozzi, Giacomo; Restelli, Antonella; Garlaschi, M.L.; Torresani, Erminio; Zirpoli, Pasquale; Marras, Emanuela; Perletti, Gianpaolo

doi:10.1016/j.ijantimicag.2006.09.027

Cited by 32 publications

(28 citation statements)

References 30 publications

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“…Azithromycin was administered only during the first 3 consecutive days at the beginning of each week of treatment with the fluoroquinolone (''pulse therapy''), as previously described. 18,28,29 In agreement with the algorithm recommended by Wagenlehner and Naber, 30 patients remained on continuous treatment with the alphaadrenoceptor blocker alfuzosin ER (10 mg day 21 ) for a period of 6 months, during which time a supplement containing Serenoa repens extract (640 mg day 21 ), lycopene (5 mg day 21 ) and selenium (50 mg day 21 ) in a single formulation was also administered. 31 Four weeks after the end of antimicrobial treatment, the patients were subjected to a complete diagnostic protocol, including microbiological and clinical evaluations.…”

Section: Diagnostic Proceduresmentioning

confidence: 92%

“…After completing clinical and microbiological evaluations at the baseline visit (visit time point 0, V0), patients were treated for 4 weeks with a fluoroquinolone-macrolide combination described in detail in previous reports. 4,18,27 An oral once-daily 750-mg dose of ciprofloxacin was combined with a 500-mg dose of azithromycin. Azithromycin was administered only during the first 3 consecutive days at the beginning of each week of treatment with the fluoroquinolone (''pulse therapy''), as previously described.…”

Section: Diagnostic Proceduresmentioning

confidence: 99%

“…16,17 We previously reported the outcome of a 6-week combination therapy protocol administered to CBP patients that was based on a single 500-mg daily dose of ciprofloxacin (cumulative dose: 21 g) and a thrice-weekly 500-mg dose of azithromycin. 18 Although treatment was effective and well tolerated, patients described the treatment as lengthy and difficult to comply with. In addition, in about 35% of the cases, a second course of treatment was necessary to achieve permanent eradication of the causative pathogens.…”

Section: Introductionmentioning

confidence: 99%

“…In addition, in about 35% of the cases, a second course of treatment was necessary to achieve permanent eradication of the causative pathogens. 18 In an attempt to combine better eradication rates with shorter courses of treatment, this therapeutic scheme was subsequently modified to administer the same cumulative dose of 21 g of ciprofloxacin at the rate of 750 mg day 21 for 4 weeks. The present retrospective study was aimed at comparing the microbiological, microscopic and clinical findings of the two treatment schemes.…”

Section: Introductionmentioning

confidence: 99%

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Fluoroquinolone–macrolide combination therapy for chronic bacterial prostatitis: retrospective analysis of pathogen eradication rates, inflammatory findings and sexual dysfunction

Magri¹,

Montanari²,

Škerk³

et al. 2011

Asian J Androl

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We previously demonstrated the safety and efficacy of fluoroquinolone-macrolide combination therapy in category II chronic bacterial prostatitis (CBP). The aim of this study is to retrospectively compare the microbiological and clinical findings of two treatment schemes for CBP based on the combination of azithromycin (500 mg, thrice-weekly) with a once-daily 500-or 750-mg dose of ciprofloxacin (Cipro-500 or Cipro-750 cohort, respectively). Combined administration of azithromycin (1500 mg week 21 ) with ciprofloxacin at the rate of 750 mg day 21 for 4 weeks rather than at 500 mg day 21 for 6 weeks increased the eradication rates from 62.35% to 77.32% and the total bacteriological success from 71.76% to 85.57%. A significant decrease in pain and voiding signs/symptoms and a significant reduction in inflammatory leukocyte counts and serum prostate-specific antigen (PSA) were sustained throughout an 18-month follow-up period in both groups. Ejaculatory pain, haemospermia and premature ejaculation were significantly attenuated on microbiological eradication in both groups, but the latter subsided more promptly in the Cipro-750 cohort. In total, 59 Cipro-750 patients showed mild-to-severe erectile dysfunction (ED) at baseline, while 22 patients had no ED on microbiological eradication and throughout the follow-up period. In conclusion fluoroquinolone-macrolide therapy resulted in pathogen eradication and CBP symptom attenuation, including pain, voiding disturbances and sexual dysfunction. A once-daily 750-mg dose of ciprofloxacin for 4 weeks showed enhanced eradication rates and lower inflammatory white blood cell counts compared to the 500-mg dose for 6 weeks. Our results are open to further prospective validation.

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Section: Diagnostic Proceduresmentioning

confidence: 92%

Section: Diagnostic Proceduresmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Fluoroquinolone–macrolide combination therapy for chronic bacterial prostatitis: retrospective analysis of pathogen eradication rates, inflammatory findings and sexual dysfunction

Magri¹,

Montanari²,

Škerk³

et al. 2011

Asian J Androl

Self Cite

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“…On completion of treatment (one or two cycles), patients were subjected to a complete diagnostic protocol, including microbiological and clinical evaluations. Patients showing microbiological persistence after 6 weeks of treatment were subjected to a second course of therapy, according to a protocol published earlier [30]. T1 was defined as the time point at which, after a first or second course of combination therapy, microbiological eradication was achieved, or, in the case of lack of eradication after a second cycle of therapy, pathogen persistence was observed.…”

Section: Effect Of Pharmacological Treatment In Patients Diagnosed Wimentioning

confidence: 99%

Semen analysis in chronic bacterial prostatitis: diagnostic and therapeutic implications

Magri¹,

Wagenlehner²,

Montanari³

et al. 2009

Asian J Androl

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The significance and diagnostic value of semen analysis in chronic bacterial prostatitis has been extensively debated and remains controversial. To investigate the diagnostic relevance of semen culture in the bacteriological workup of prostatitis patients, we retrospectively analyzed a clinical database of 696 symptomatic patients. All patients were routinely subjected to a four-glass test, followed by semen culture and analysis. This allowed to dissect from the database three different diagnostic scenarios, and to compare the 'two-glass' pre-/post-massage test and the standard 'four-glass' test with a 'five-glass' test (four-glass plus post-VB3 semen culture). The 'five-glass' test showed 3.6-or 6.5-fold increases in relative sensitivity and lesser reductions (-13.2% or -14.7%) in relative specificity for traditional uropathogens (TUs) compared with the four-glass or two-glass test, respectively. The area under the ROC curve and Jouden's index were increased, whereas positive and negative likelihood ratios were lower than comparators, indicating that the 'five-glass' assay may be superior in confirming the negative outcome of both standard tests. The five-, four-, and two-glass tests detected TUs (Enterobacteriaceae, Enterococci, etc.) in 120, 33, and 20 patients and unusual pathogens (Streptococci, other Gram-positive species, Mycoplasmata, and others) in 130, 56, and 45 patients, respectively. When patients were subjected to pharmacological treatment, including a combination of a fluoroquinolone and a macrolide, no differences in eradication rates were observed between groups diagnosed with different tests, irrespective of pathogen category. Eradication was associated with long-term sign/symptom remission; no significant intergroup differences in sign/symptom scores were observed throughout a 24-month off-therapy follow-up period. In conclusion, our data support the usefulness of semen analysis in the diagnostic workup of prostatitis patients when this test is used to complement the four-glass Meares and Stamey test. Improvement of microbiological assays conveys important diagnostic and therapeutic implications.

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Phytotherapy of Benign Prostatic Hyperplasia. A Minireview

Pagano

Laudato

Griffo

et al. 2013

Phytotherapy Research

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Benign prostate hyperplasia (BPH) is a common condition affecting older men, with an incidence that is age-dependent. Histological BPH, which typically develops after the age of 40 years, ranges in prevalence from >50% at 60 years to as high as 90% by 85 years of age. Typical symptoms include increased frequency of urination, nocturia, urgency, hesitancy, and weak urine stream. Conventional medicines used for the treatment of BPH include alpha blockers and 5-alpha reductase inhibitors. This articles review the mode of action, the efficacy, and the safety, including herb-drug interactions of the most common botanicals (Serenoa repens, Pygeum africanum, Urtica dioica, and Cucurbita pepo) and nutraceuticals (isoflavones, lycopene, selenium, and β-Sitosterol) in controlling the lower urinary tract symptoms associated to BPH.

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Efficacy of repeated cycles of combination therapy for the eradication of infecting organisms in chronic bacterial prostatitis

Cited by 32 publications

References 30 publications

Fluoroquinolone–macrolide combination therapy for chronic bacterial prostatitis: retrospective analysis of pathogen eradication rates, inflammatory findings and sexual dysfunction

Fluoroquinolone–macrolide combination therapy for chronic bacterial prostatitis: retrospective analysis of pathogen eradication rates, inflammatory findings and sexual dysfunction

Semen analysis in chronic bacterial prostatitis: diagnostic and therapeutic implications

Phytotherapy of Benign Prostatic Hyperplasia. A Minireview

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