Antibiothérapie des prostatites

Abstract

Objectives of the study Due to the frequency of acute bacterial prostatitis, the choice of antibiotic therapy is discussed in this study. Classification of prostatitis The choice of suitable antibiotics is relatively easy in cases of acute prostatitis, but it is by far more difficult in chronic forms. In the acute primary form, fluoroquinolones administered per os achieve intra-prostatic concentrations much higher than plasma concentrations. Thus these drugs constitute the best therapeutic choice, taking into account the predominance of E. coli, isolated in 76% in urinary cyto-bacteriologic examination (UCBE). Treatment duration The duration of treatment is a matter of debate and a professional consensus recommends a minimum of 3 weeks. In secondary acute forms (after biopsies or catheterisation), antibiotic therapy should be based on bacteria responsible for infection. In chronic forms Antibiotic therapy in chronic forms or in recurrent forms requires the isolation and identification of the organism(s), either by UCBE, or by the Meares and Stamey test. Microbial ecology is variable and the choice of antibiotic should be based upon bacterial identification. The duration of therapy must also be discussed in this situation and a professional consensus recommends 4 to 6 weeks treatment. Conclusion It is important to identify the pathogen responsible for prostatitis (UCBE in acute forms, Meares and Stamey in recurrent forms). The duration of treatment by fluoroquinolones must be prolonged ≥ 3 weeks.