Levofloxacin versus ciprofloxacin in the treatment of chronic bacterial prostatitis: a randomized double-blind multicenter study

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

“…Table 2 lists the microorganisms isolated from prostate-specific specimens and the per-pathogen eradication data. Consistent with data in other reports, 39 the most represented pathogen was Enterococcus faecalis (total 74 isolates) followed by Escherichia coli (57 isolates). In the Cipro-750 group, a significantly higher proportion of eradicated E. faecalis was recorded (x 2 55.15, P50.023; Table 2).…”

“…The combination of 500 mg day 21 azithromycin (thrice-weekly, the first 3 consecutive days of each week as in the present trial) and 1000 mg day 21 ciprofloxacin for 4 weeks resulted in pathogen eradication in 83.9% of the cases (assessed at 4 weeks post-therapy), whereas singleagent ciprofloxacin treatment (1000 mg day 21 for 4 weeks) resulted in a much lower rate of microbiological eradication (62%). Importantly, in the Croatian cohort, ciprofloxacin-azithromycin combination therapy was associated with a lower CBP relapse rate (22.6% at 6 months) compared with ciprofloxacin single-agent therapy in their study (48.3%) and published monotherapy studies (28% in two studies by Bundrick et al 39 and Naber et al 10 ). A strikingly low infection relapse rate was recorded in the present retrospective study.…”

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

“…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].…”

“…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].…”

Prulifloxacin: a review focusing on its use beyond respiratory and urinary tract infections

“…Mean prostate tissue/plasma concentration ratios following antibiotic administration ranged from 3.8 to 9.5 [36]. In addition, ulifloxacin is not only highly active against commonly involved Gram-negative pathogens (E. coli, K. pneumoniae, P. mirabilis) but also displays some activity against Grampositive bacteria, including Enterococcus and Staphylococcus spp., which have recently been found to play an important role in CBP [37,38]. Another advantage of this antibiotic in the CBP setting is its immunomodulating effect.…”