Treatment of Bacterial Prostatitis

Abstract

Prostatitis is characterized by voiding symptoms and genitourinary pain and is sometimes associated with sexual dysfunction. Up to 25% of men receive a diagnosis of prostatitis in their lifetime, but <10% have a proven bacterial infection. The causes and treatment of nonbacterial prostatitis are largely unknown, but bacterial prostatitis is caused by infection with uropathogens, especially gram-negative bacilli, although infection is sometimes due to gram-positive and atypical microorganisms. Acute bacterial prostatitis is easily diagnosed (by abrupt urogential and often systemic symptoms, along with bacteriuria) and treated (by systemic antibiotic therapy). Chronic bacterial prostatitis is characterized by prolonged or recurrent symptoms and relapsing bacteriuria; diagnosis traditionally requires comparing urinary specimens obtained before with specimens obtained after prostatic massage. Treating chronic bacterial prostatitis requires prolonged therapy with an antibiotic that penetrates the prostate (ie, one with high lipid solubility, a low degree of ionization, high dissociation constant, low protein binding, and small molecular size). We review recent pharmacological and clinical data on treating bacterial prostatitis.

Prostate Biopsy Related Acute Bacterial Prostatitis: Current Microbiological Spectrum, Sensitivity to Antibiotics And Clinical Findings In Turkey

“…In some cases, prostatitis is caused by atypical pathogens. [10,11] Sterile urine cultures in ABP patients may be because of the previous use of antibiotics.…”

“…Treatment of AMP usually lasts for 2 weeks, although it can continue for up to 4 weeks in complicated cases. [10] Resistance to fluoroquinolone is increasingly becoming a major problem, and these cases require treatment with third-generation cephalosporins or carbapenem. Resistance to ciprofloxacin was 55% in 2011, while it has been recently reported to reach 90%.…”

The inflammatory journey of a prostatitis patient

“…8 Differentiating true prostatitis from non-bacterial syndromes requires the development of accurate diagnostic tests. 9 In order to gather clear and relevant data, these tests must be carried out before any antibiotic therapy has commenced. Used in isolation, the PPMT has its limitations; however, when used in combination with other diagnostic tools, it can be a valuable asset.…”

Pathogenetic Influences of Human Herpesvirus 8 (HHV-8) in Prostate Cancer Progression

“…Prostatic infections are assumed to be fairly common yet are never diagnosed in the majority of cases (97,133,134). Studies should be undertaken to determine how frequently malignant prostates harbor infections and how other infectious agents, such as P. acnes and E. coli, affect the tumor microenvironment and disease course.…”