Fluoroquinolone antimicrobial agents in the treatment of prostatitis and recurrent urinary tract infections in men

Abstract

Chronic bacterial prostatitis is the most frequent cause for recurrent urinary tract infection in young and middle-aged men. The selection of an appropriate antimicrobial agent that has optimal pharmacokinetics for urine and prostatic secretion and tissue is important in both entities. Fluoroquinolones possess several pharmacologic characteristics that favor them for treatment of urinary tract infection and prostatitis. The pharmacokinetics of fluoroquinolones and the theoretical background of drug penetration into the prostate are outlined. Analyzing the concentrations of various fluoroquinolones in urine, prostatic and seminal fluid, and in prostatic tissue, it becomes obvious that the fluoroquinolones differ in plasma concentrations and in their concentrations at these sites. Nevertheless, overall, the concentrations at the site of infection of most of the fluoroquinolones should be sufficient for the treatment of chronic bacterial prostatitis and vesiculitis and recurrent urinary tract infection in men caused by susceptible pathogens.

The Commonest Uropathogens Causing Urinary Tract Infection Among Patients Attending a Tertiary Care Hospital in Eastern Bihar, and Their Antibiogram

“…Resistance to ciprofloxacin has emerged in a variety of genera belonging to the family Enterobacteriaceae. Our findings concur with such findings reported earlier [32,33] . Apart from the notable resistance of E. coli to ciprofloxacin, other organisms were also found to be resistant to ciprofloxacin especially K. pneumoniae, Pseudomonas spp., Proteus spp., Enterobacter spp., Staphylococcus spp, and E. faecalis.…”

General Principles of Antimicrobial Therapy

“…Fluoroquinolones achieve high concentrations in the prostate and are preferred oral agents for the treatment of prostatitis. 17 Daptomycin, an excellent bactericidal agent against gram-positive bacteria, is not useful for treatment of pneumonia (eg, pneumococcal pneumonia) because it is inactivated by lung surfactant. 18 Many antibiotics (eg, aminoglycosides) are less active in the low-oxygen, low-pH, and high-protein environment of abscesses, and drainage of abscesses to enhance antimicrobial efficacy is recommended when possible.…”

Population Pharmacokinetic Modeling of the Unbound Levofloxacin Concentrations in Rat Plasma and Prostate Tissue Measured by Microdialysis

“…hronic bacterial prostatitis is frequently associated with recurrent urinary tract infections (UTIs) in young and middle-aged men and is caused mainly by Enterobacteriaceae family pathogens, especially Escherichia coli (1). Treatment of bacterial prostatitis is still difficult due to two main reasons.…”