Современные подходы к лечению хронического бактериального простатита.

Abstract

Introduction. The main treatment option for chronic bacterial prostatitis (CBP) is antimicrobial therapy. However, in connection with the steady increase in resistance to antimicrobial drugs and the high rate of failure in the treatment of such patients, it seems relevant to study new approaches to the treatment of this disease. Materials and methods. The review is based on articles published over the past 10 years (2011-2021) in scientific peer-reviewed journals included in the PubMed databases (https://www.ncbi.nlm.nih.gov/pubmed/) and the Scientific Electronic Library Elibrary.ru (https://elibrary.ru/). The search was carried out for the following keywords: «prostatitis», «chronic prostatitis», «chronic bactrial prostatitis», «chronic infectious prostatitis». At the first stage, 477 sources were found that were relevant to the topic of the review, of which 70 articles were selected for the final version of the review. Results. Oral antibiotic therapy remains the mainstay of treatment for CBP. There is a tendency towards an increase in resistance to traditionally used antimicrobial agents (fluoroquinolones, trimethoprim-sulfamethoxazole, etc.). In this regard, the possibilities of alternative antibacterial drugs (fosfomycin, etc.) and other methods of treatment are actively used and are being studied: direct administration of antimicrobial drugs into the prostate gland, chronic oral antibiotic prophylaxis, phage therapy and surgical interventions. An important role in the treatment of CBP is assigned to other pharmacological groups of drugs and non-drug methods of treatment (primarily physiotherapeutic methods). Conclusion. Many therapies that are used in addition to or instead of oral antibiotic therapy still cannot be recommended for use in general clinical practice, since there is currently a lack of sufficient evidence of their effectiveness and safety. Therefore, considering the existing problems of treating such patients, the need to continue studies to assess the possibilities of new promising approaches to the treatment of CBP remains relevant.