Ertapenem as treatment for ESBL producing E coli prostatitis

Abstract

Background: Prostatitis presents one of the most common entities encountered in urologic practice. Treating ESBL producing enterobacteriaecea urinary tract infections is a major problem especially in prostatitis because of the absence of active transporters for antibiotics and a relatively low prostate penetration of these drugs. Thus, therapeutic options are limited in infections with such resistant bacteria and require the use of carbapenems in the majority of the cases. Ertapenem is used in acute bacterial prostatitis yet not been approved by the FDA for this indication. The goal of this study is to compare the efficacy of ertapenem as to other antibiotics in the treatment of prostatitis with ESBL producing E. Coli. Methods & Materials: It is a comparative retrospective study of the files of patients admitted in a tertiary care hospital between 1st July 2008 and 1st July 2014 treated for acute bacterial prostatitis caused by E. Coli producing ESBL with ertapenem and other antibiotics. Results: The mean age of the 110 patients of this study was 69.58 years. Ertapenem was administered without previous efficient antibiotic treatment in 34 cases. 18.18% recurred in a period of three months. 85% of recurrences were caused by ESBL producing E.Coli (15.45%). 17% and 19% of patients treated with meropenem and imipenem respectively recurred in a 3 months period. Conclusion: Ertapenem is as effective as other carbapenems in treatment of E.Coli producing ESBL and is not associated with a higher recurrence rate.