Efficacy Of Antibiotic Therapy Research Articles

PDIA iminosugar influence on subcutaneous Staphylococcus aureus and Pseudomonas aeruginosa infections in mice.

Biofilm-associated infections persist as a therapeutic challenge in contemporary medicine. The efficacy of antibiotic therapies is ineffective in numerous instances, necessitating a heightened focus on exploring novel anti-biofilm medical strategies. Among these, iminosugars emerge as a distinctive class of compounds displaying promising biofilm inhibition properties. This study employs an in vivo wound infection mouse model to evaluate the effectiveness of PDIA in treating biofilm-associated skin wound infections caused by Staphylococcus aureus and Pseudomonas aeruginosa. Dermic wounds in mice were infected with biofilm-forming strains, specifically S. aureus 48 and P. aeruginosa 5, which were isolated from patients with diabetic foot, and are well-known for their strong biofilm formation. The subsequent analysis included clinical, microbiological, and histopathological parameters. Furthermore, an exploration into the susceptibility of the infectious strains to hydrogen peroxide was conducted, acknowledging its potential presence during induced inflammation in mouse dermal wounds within an in vivo model. The findings revealed the efficacy of PDIA iminosugar against the S. aureus strain, evidenced by a reduction in bacterial numbers within the wound and the inflammatory focus. This study suggests that PDIA iminosugar emerges as an active and potentially effective antibiofilm agent, positioning it as a viable treatment option for staphylococcal infections.

Equine dental sinusitis—A statistical analysis of the effect of antibiotics on dental sinusitis following dental extraction

SummaryBackgroundAntibiotic resistance is an increasing global threat to human and veterinary practices. The relevance and efficacy of antibiotic therapy in the treatment of various diseases has been poorly documented in the literature. One such disease is equine sinusitis secondary to dental disease where dental extraction is most often combined with broad‐spectrum antibiotic treatment. It, however, remains undocumented if antibiotic treatment reduces the risk of complication in horses where the diseased tooth is removed by extraction.ObjectivesThe aim of this study was to analyse the effects of perioperative antibiotics in horses with dental sinusitis treated by dental extraction with or without concurrent antibiotic treatment.Study designRetrospective cohort study.MethodsClinical records from horses presenting with nasal discharge between September 2016 and May 2022 were reviewed. Horses with sinusitis secondary to dental disease were identified, and data from clinical records were collected supplemented by online questionnaires. The final statistical model was built using logistic regression.ResultsA total of 59 horses with dental sinusitis were included in the study. Following dental extraction, 62.5% (15/24) of horses that did receive perioperative antibiotics and 60% (21/35) of horses that did not receive perioperative antibiotics were successfully treated without the need for further treatment. The final model showed no significant difference on the probability of success (p = 0.85) between treatment with and without antibiotics.Main limitationsThe retrospective nature of this study may increase the risk of biases in relation to data collection and follow‐up information and the limited number of individuals available for the analysis.ConclusionsThese findings indicate that the use of perioperative antibiotics does not influence the likelihood of complications or the probability of a successful outcome in horses with dental sinusitis undergoing dental extraction.

Is it time for a moratorium on the use of benzalkonium chloride in eyedrops?

Is it time for a moratorium on the use of benzalkonium chloride in eyedrops?

Animal experimental investigation on the efficacy of antibiotic therapy with linezolid, vancomycin, cotrimoxazole, and rifampin in treatment of periprosthetic knee joint infections by MRSA.

AimsPeriprosthetic joint infections (PJIs) are rare, but represent a great burden for the patient. In addition, the incidence of methicillin-resistant Staphylococcus aureus (MRSA) is increasing. The aim of this rat experiment was therefore to compare the antibiotics commonly used in the treatment of PJIs caused by MRSA.MethodsFor this purpose, sterilized steel implants were implanted into the femur of 77 rats. The metal devices were inoculated with suspensions of two different MRSA strains. The animals were divided into groups and treated with vancomycin, linezolid, cotrimoxazole, or rifampin as monotherapy, or with combination of antibiotics over a period of 14 days. After a two-day antibiotic-free interval, the implant was explanted, and bone, muscle, and periarticular tissue were microbiologically analyzed.ResultsVancomycin and linezolid were able to significantly (p < 0.05) reduce the MRSA bacterial count at implants. No significant effect was found at the bone. Rifampin was the only monotherapy that significantly reduced the bacterial count on implant and bone. The combination with vancomycin or linezolid showed significant efficacy. Treatment with cotrimoxazole alone did not achieve a significant bacterial count reduction. The combination of linezolid plus rifampin was significantly more effective on implant and bone than the control group in both trials.ConclusionAlthough rifampicin is effective as a monotherapy, it should not be used because of the high rate of resistance development. Our animal experiments showed the great importance of combination antibiotic therapies. In the future, investigations with higher case numbers, varied bacterial concentrations, and changes in individual drug dosages will be necessary to be able to draw an exact comparison, possibly within a clinical trial.Cite this article: Bone Joint Res 2022;11(3):143–151.

Clinical Features in Patients With PANDAS/PANS and Therapeutic Approaches: A Retrospective Study.

Objective: The clinical characteristics of patients with PANDAS (pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection) and PANS (pediatric acute-onset neuropsychiatric syndrome) and the efficacy of antibiotic therapy with psychotherapy and antipsychotics were investigated to improve neurological symptoms as well as obsessive compulsive disorder (OCD).Methods: We retrospectively analyzed 62 patients with a clinical diagnosis of PANDAS/PANS enrolled from May 14, 2013 to September 15, 2020 in the Neurology Childhood Division, Department of Pediatrics at Sapienza, Rome. Clinical manifestations, neurological and psychiatric, laboratory investigations, and familiar history were collected to evaluate the differences between the two groups. The effects of various therapeutic approaches were examined. Descriptive and comparative statistical analyses were performed.Results: The mean age at onset of PANDAS/PANS symptoms was 6.2 ± 1.2 years. The most common diagnosis was PANDAS, followed by PANS. Neurological and psychiatric symptoms were mostly evident in both groups (>70% of the population), with no significant difference between them (P = 0.52 and P = 0.15, respectively). Irritability, aggressivity, and food restriction were more prevalent in children with PANS than in those with PANDAS (P = 0.024 and P = 0.0023, respectively). The levels of anti-streptolysin O and anti-DNAse B 10-fold higher in PANDAS than those in PANS (P < 0.0001). Antibiotics or psychotherapy were administered in most cases (90.3 and 53.2%, respectively), followed by antipsychotic treatments (24.2%). In the multivariate analysis, among the therapies used, psychotherapy significantly resulted in the most efficacious relief of OCD, reducing stress in patients and their parents (P = 0.042).Conclusion: Our findings confirm a clear clinical difference between the two groups, PANDAS and PANS, using different approaches. In fact, irritability, aggressivity, and food restriction were significantly more frequent in children with PANS and the levels of anti-streptolysin O and anti-DNAse B were higher in PANDAS. Another relevant finding is the efficacy of psychotherapy, especially for obsessive-compulsive disorder, and of antibiotic prophylaxis in managing acute neurological symptoms.

Does Antibiotic Therapy Affect Time to Clearance in Post-Active Phase Streptococcal Guttate Psoriasis—A Case Control Study

Background: The extent of the role of streptococcal infection in the pathogenesis of guttate psoriasis is still unclear. Data on the efficacy of antibiotic therapy in guttate psoriasis is limited, heterogeneous and conflicting. Objective: We sought to ascertain whether single-course oral antibiotic therapy affects time to skin clearance in acute post-active phase streptococcal guttate psoriasis. Methods: We performed a 5-year case-control study of ASOT-positive guttate psoriasis treated with or without single-course oral antibiotic therapy with 8-week follow-up. Results: There was no significant difference between cases and controls for time to clearance (χ2 = 0.92, p = 0.82). Conclusion: Our findings suggest that single-course oral antibiotic therapy may not provide any adjunctive therapeutic benefit in the treatment of acute post-active phase streptococcal guttate psoriasis.

Using Patient History to Guide Empiric Antibiotic Therapy for Urinary Tract Infection

For the individual patient, the efficacy of antibiotic therapy is crucially dependent on matching the correct antibiotic to the pathogen's antibiotic

Pharmacokinetics of meropenem in burn patients with infections caused by Gram-negative bacteria: Are we getting close to the right treatment?

Infections caused by multidrug-resistant Gram-negative bacteria are associated with high mortality. A relevant concern is the efficacy of antibiotic therapy in burn patients in whom pathophysiological changes strongly influence pharmacokinetic (PK) parameters. This study aimed to describe the PK parameters of meropenem in a population of burn patients. Blood samples were collected immediately before and 2 h and 5 h after the start of intravenous drug administration. Plasma meropenem concentrations were determined using an ultra-performance liquid chromatography-photodiode array method. Seventeen burn patients were enrolled in the study. Thirteen patients (76%) were treated with meropenem for infections byPseudomonas aeruginosa or Acinetobacter baumannii isolated from blood or wounds. Mean Cmax, Cmin, AUC0-24, half-life, drug clearance and volume of distribution were 28.9 mg/L, 3.7 mg/L, 280.2 mg h/L, 2.0 h, 19.0 L/h and 44.4 L, respectively. Six patients (35%) achieved a Cmin ≥3.3 mg/L and seven patients (41%) achieved a Cmax ≥ 28.4 mg/L, whilst nine patients (53%) achieved an AUC0-24 of >226 mg h/L. Given a minimum inhibitory concentration (MIC) of 0.5 mg/L, all patients satisfied the target AUC/MIC of >125, but when the MIC rises to 2 mg/L (the ECOFF), only five patients reached the desired AUC/MIC. Regarding fT>MIC at an MIC of 2 mg/L with a 2-h infusion time, 13 patients (76%) achieved the PK target (>75%). These data suggest that a combined 2-h infusion with a higher dosage of meropenem, including a loading dose, may be successful to achieve effective PK parameters.

LUNG ULTRASONOGRAPHY IN PNEUMONIA

Aim. In order to optimize the diagnosis of pneumonia by including lung ultrasonography in the diagnostic algorithm for pneumonia, the main ultrasound signs of inflammatory infiltration of the lungs were identified, depending on the form of morphological substrate, and the capabilities of ultrasound examination in monitoring pneumonia were evaluated.Material and Methods. A total of 96 patients were admitted to hospital by emergency to rule out/to confirm pneumonia based on X-ray diagnosis of this pathology in 81 persons. Ultrasonic examination was performed in all patients at a day of admission to hospital. Dynamics in inflammatory infiltrate was evaluated in 55 patients at days 3–4, 7, and 10–14 of hospital stay.Results. The ultrasonic signs of inflammatory infiltrate were found in 55 of 96 patients with prevalent ultrasound pattern of pleuropneumonia (n=48; 50%) and bronchopneumonia in a smaller number of patients (n=7; 8.6%). The results of ultrasonography showed the low sensitivity (69.7%) and significantly high specificity (100%) rates of the method in detecting pneumonia. Positive dynamics in ultrasonic monitoring of pneumonia was detected in the overwhelming number of patients (n=45; 81.8%) at day 3 of hospitalization. Negative dynamics (n=3; 5.5%) was observed at days 3 and 7 of the study.Conclusion. Ultrasonic study may be considered a useful step in the diagnostic algorithm for patients with pneumonia as this method provides additional information for an attending physician and does not involve adverse effects of ionizing radiation on patient’s body. Since the ultrasonic data on positive and negative dynamics of pneumonia were received ahead of the results of standard control radiography and were verified by further clinical and radiological observations, the role of ultrasonic monitoring of the inflammatory infiltrate was essential for evaluation of the efficacy of antibiotic therapy at earlier time.

LUNG ULTRASONOGRAPHY IN PNEUMONIA

Aim. In order to optimize the diagnosis of pneumonia by including lung ultrasonography in the diagnostic algorithm for pneumonia, the main ultrasound signs of inflammatory infiltration of the lungs were identified, depending on the form of morphological substrate, and the capabilities of ultrasound examination in monitoring pneumonia were evaluated.Material and Methods. A total of 96 patients were admitted to hospital by emergency to rule out/to confirm pneumonia based on X-ray diagnosis of this pathology in 81 persons. Ultrasonic examination was performed in all patients at a day of admission to hospital. Dynamics in inflammatory infiltrate was evaluated in 55 patients at days 3–4, 7, and 10–14 of hospital stay.Results. The ultrasonic signs of inflammatory infiltrate were found in 55 of 96 patients with prevalent ultrasound pattern of pleuropneumonia (n=48; 50%) and bronchopneumonia in a smaller number of patients (n=7; 8.6%). The results of ultrasonography showed the low sensitivity (69.7%) and significantly high specificity (100%) rates of the method in detecting pneumonia. Positive dynamics in ultrasonic monitoring of pneumonia was detected in the overwhelming number of patients (n=45; 81.8%) at day 3 of hospitalization. Negative dynamics (n=3; 5.5%) was observed at days 3 and 7 of the study.Conclusion. Ultrasonic study may be considered a useful step in the diagnostic algorithm for patients with pneumonia as this method provides additional information for an attending physician and does not involve adverse effects of ionizing radiation on patient’s body. Since the ultrasonic data on positive and negative dynamics of pneumonia were received ahead of the results of standard control radiography and were verified by further clinical and radiological observations, the role of ultrasonic monitoring of the inflammatory infiltrate was essential for evaluation of the efficacy of antibiotic therapy at earlier time.

Effects of antibiotic therapy in women with the amniotic fluid “sludge” at 15–24 weeks of gestation on pregnancy outcomes

Objective: The aim of this prospective study was to assess the efficacy of antibiotic therapy for the prevention of adverse pregnancy outcomes in women with the amniotic fluid “sludge” at 15–24 weeks of gestation.Methods: 245 women underwent transvaginal ultrasound cervical length measurement at 15–24 weeks of pregnancy and 29 out of them with amniotic fluid “sludge” were included in the study. Eight women with the “sludge” had cervical length >25 mm (Group I), seven—an asymptomatic short cervix (Group IIa) and 14 women with a short cervix had symptoms like low abdominal pain, back pain, and menstrual-like cramps (Group IIb). All participants received intravenous, oral and/or vaginal antibiotic therapy. Participants in Group IIa were additionally given vaginal progesterone (VP), and in Group IIb—VP and indomethacin. Placentas from women with preterm birth (PTB) underwent histological examination.Results: The amniotic fluid “sludge” detected at an ultrasound scan between 15–24 weeks of gestation was associated with long-term maternal infections, histological chorioamnionitis, and was viewed as a marker of intra-amniotic infection. Absence of intravenous antibiotic therapy during midtrimester of pregnancy in these women was associated with neonatal infection with intrauterine onset in 61.1%, postpartum endometritis in 23.1%, and rate of PTB 46.2%. Intravenous antibiotic therapy eliminated sonographic presence of the sludge and resulted in prevented of neonatal and postpartum infections, prevented the risk of PTB in women with the cervical length >25 mm, in those with an asymptomatic short cervix receiving VP, and in 70% of symptomatic women with a short cervix, who received them in combination VP/indomethacin. For those women whose approach was not fully beneficial, it allowed to delay delivery in 11–17 weeks.Conclusions: Although we found that intravenous antibiotic therapy at 15–24 weeks of gestation in women with amniotic fluid “sludge” can protect from infection-related complications and demonstrated high beneficial effects of adding antibiotics to anti-inflammatory drug (indomethacin) and/or VP in women with a short cervix, further larger studies are needed.

Concerns about Diabetic Foot Wounds

This paper in a medical sense can be described as a case report. The diabetic foot wounds of a relative, over 70 years of age, with Type I diabetes were so grievous and the medical treatment was so protracted that success could not be assured. There was a danger of amputation. The one outstanding feature was that the private application of an antifungal spray, between the toes of both feet without prescribed oral mycologic agents, seemed to make an inexplicable difference to the final outcome. In addition, a viewpoint drawn was that the efficacy of antibiotic therapies may be compromised by the presence of invisible fungal etiology.

Synthesis and biological activity of novel adamantan-based dialkylaminopropanol quaternary salts

The emergence and spread of multidrug-resistant pathogens leads to a decrease in efficacy of antibiotic therapy, prolongation of the length of patient’s hospital stay and an increase in treatment costs. The screening of potential antimicrobial agents among the new classes of chemical compounds is one of the promising methods to overcome the problem of resistance.Objectives. The synthesis and screening studies of antimicrobial activity of quaternary salts of adamantane derivatives (3a – 3l) with the aim to find of new prospective compound with good activityMaterials and methods. The synthesis and investigation of physicochemical properties of new adamantan-based dialkylaminopropanol quaternary salts were carried out. The evaluation of antimicrobial action against S. aureus, E. coli and C. albicans strains were performed.Results and discussion. The results showed that the inhibitory activities of quaternary salts with 1-adamantylethyl radical in their alkoxy group were significantly higher than those of the compounds with 1-adamantyl and 1-adamantyloxyethyl radicals in their alkoxy group.Conclusions. 3c was the most active compound tested against all strains, with MIC between 1.56 and 3.12 µg/mL, and its antimicrobial activity was similar to that of myramistin.

Sanitation of Staphylococcus aureus genotype B-positive dairy herds: A field study

Staphylococcus aureus is one of the most widespread mastitis pathogens infecting dairy cattle worldwide. In Switzerland, different bovine genotypes of Staph. aureus have been identified, and genotype B (GTB) was demonstrated to be a highly contagious subtype, causing herd problems in cattle. As the efficacy of antibiotic therapy against Staph. aureus is not satisfactory, the most promising strategy for controlling this udder pathogen is the implementation of specific sanitation programs for affected farms. The aim of the present longitudinal study was the field evaluation of 2 analytical approaches for the sanitation of Staph. aureus GTB-positive dairy herds. We compared a new real-time quantitative PCR (qPCR) assay based on the detection of the unique target gene adlb with classical bacteriology. Sanitation was successfully achieved using both analytical methods, but the qPCR approach showed some main advantages, namely the use of clean (instead of aseptically collected) milk samples facilitates sample collection in terms of time and costs, enabling the sampling of entire herds during a regular milking procedure and by the farm staff. The high inclusivity and exclusivity of the new target gene adlb enable very specific detection of only the genotype of interest. Because of the very high diagnostic sensitivity of qPCR, each GTB-positive cow can be correctly identified at any time point during lactation, allowing farmers to continuously update milking groups to prevent transmission during milking. Milk sample analysis becomes more objective, faster, less expensive, and more suitable for routine application, enabling the sanitation of even big herds in short time.

235 Association of the first phase xenobiotic biotransformation system genes with the risk of undesirable side effects and efficacy of antibiotic therapy in Russian CF children

235 Association of the first phase xenobiotic biotransformation system genes with the risk of undesirable side effects and efficacy of antibiotic therapy in Russian CF children

Role of clinical pulmonary infection score and serum C-reactive protein in detecting the efficacy of therapeutic choices in the management of Enterobacter aerogenes nosocomial pneumonia

Introduction and background Nosocomial pneumonia is the second most common nosocomial infection. It is usually bacterial in origin. Nosocomial pneumonia is responsible for 25% of infections in the ICU. Early-onset nosocomial pneumonia tends to carry a better prognosis than does late-onset nosocomial pneumonia. Patients and methods This study was planned to evaluate the role of the clinical pulmonary infection score (CPIS) and C-reactive protein (CRP) in detecting the efficacy of antibiotic therapy chosen for treatment of nosocomial Enterobacter pneumonia. In all, 200 patients admitted to the ICU who had evidence of pneumonia were included in the study. Patients were followed up by evaluating their serum CRP levels and CPIS during the first 8 days of admission. Results Enterobacter aerogenes represented 24% of nosocomial pneumonia cases in the study. An overall 70.8% of patients with E. aerogenes detected in culture and sensitivity were sensitive to both amikacin and levofloxacin. Those patients received only amikacin. Sixteen patients provided good response to amikacin. The remaining 18 patients showed poor response to amikacin therapy (proved by insignificant differences between CPIS and CRP on the first and fourth day of admission). In the case of these patients levofloxacin was added to antibiotic therapy and they were followed up for a further 4 days. The results demonstrated that 16 patients provided good response to amikacin and levofloxacin on the fifth and eighth days. Conclusion This study demonstrated that CPIS and serum CRP can be used as indicators of the efficacy of antibiotics in nosocomial pneumonia.

Effect of Saccharomyces boulardii on Eradication of H. pylori Infection

Standard therapies for Helicobacter pylori infection are weakening in effectiveness as antibiotic resistance grows. One suggested approach to improving the efficacy of antibiotic therapies is through supplementation with probiotics, which has shown some initially promising results. Researchers have now augmented a prior meta-analysis with new studies of supplementation with a single …

A Spiral in the Heart: Mitral Valve Endocarditis with Unusual Vegetation Shape Potentially Affecting Effectiveness of Antibiotic Therapy.

We report an unusual case of infective endocarditis (IE) in an 88-year-old woman, occurring on a prolapsing mitral valve and characterized by an atypical vegetation shape resembling a spiral-like appearance. After the patient refused surgical correction, persistent IE despite prolonged antibiotic therapy was observed, resulting in an ischemic stroke probably secondary to septic embolus. The importance of vegetation shape in the management of patients with IE was classically related to the increased risk of embolization associated with pedunculated, irregular, and multilobed masses. We hypothesize that the unusual spiral-like vegetation shape in our patient may have favored IE persistence by two mechanisms, namely, a decrease of the exposed vegetation surface with creation of an internal core where the penetration of antimicrobial agents was obstacled and the creation of blood turbulence within the vegetation preventing a prolonged contact with circulating antibiotics. These considerations suggest that vegetation shape might be considered of importance in patients with IE not only because of its classical association with embolization risk, but also because of its potential effect on the efficacy of antibiotic therapy.

Maternal intravenous treatment with either azithromycin or solithromycin clears Ureaplasma parvum from the amniotic fluid in an ovine model of intrauterine infection.

Intrauterine infection with Ureaplasma spp. is strongly associated with preterm birth and adverse neonatal outcomes. We assessed whether combined intraamniotic (IA) and maternal intravenous (IV) treatment with one of two candidate antibiotics, azithromycin (AZ) or solithromycin (SOLI), would eradicate intrauterine Ureaplasma parvum infection in a sheep model of pregnancy. Sheep with singleton pregnancies received an IA injection of U. parvum serovar 3 at 85 days of gestational age (GA). At 120 days of GA, animals (n=5 to 8/group) received one of the following treatments: (i) maternal IV SOLI with a single IA injection of vehicle (IV SOLI only); (ii) maternal IV SOLI with a single IA injection of SOLI (IV+IA SOLI); (iii) maternal IV AZ and a single IA injection of vehicle (IV AZ only); (iv) maternal IV AZ and a single IA injection of AZ (IV+IA AZ); or (v) maternal IV and single IA injection of vehicle (control). Lambs were surgically delivered at 125 days of GA. Treatment efficacies were assessed by U. parvum culture, quantitative PCR, enzyme-linked immunosorbent assay, and histopathology. Amniotic fluid (AF) from all control animals contained culturable U. parvum. AF, lung, and chorioamnion from all AZ- or SOLI-treated animals (IV only or IV plus IA) were negative for culturable U. parvum. Relative to the results for the control, the levels of expression of interleukin 1β (IL-1β), IL-6, IL-8, and monocyte chemoattractant protein 2 (MCP-2) in fetal skin were significantly decreased in the IV SOLI-only group, the MCP-1 protein concentration in the amniotic fluid was significantly increased in the IV+IA SOLI group, and there was no significant difference in the histological inflammation scoring of lung or chorioamnion among the five groups. In the present study, treatment with either AZ or SOLI (IV only or IV+IA) effectively eradicated macrolide-sensitive U. parvum from the AF. There was no discernible difference in antibiotic therapy efficacy between IV-only and IV+IA treatment regimens relative to the results for the control.

Efficacy analysis of antidepressant-assisted treatment for chronic prostatitis

Objective To explore the effect of antidepressant adjuvant treatment for chronic prostatitis (CP),and to find an effective treatment for the clinical therapy of CP.Methods 88 patients with CP were randomly divided into two groups,the control group 41 patients were treated with the antibacterials moxifloxacin,the treatment group 47 patients were treated with the moxiiloxacin treatment and paroxetine adjuvant therapy.The clinical symptoms,life quality (QOL) and Zung depression scale score of the two groups were evaluated and compared.Results After four weeks of treatment,voiding difficulty endless,urinary urgency,perineal discomfort symptoms of the treatment group were improved significantly compared with the control group (x2 =23.563,18.348,15.874,all P ＜ 0.05).After four weeks of treatment,QOL,Zung depression scale scores the treatment group were more significant decline than before treatment and the control group after treatment (t =0.554,0.615,0.382,0.336,all P ＜ 0.05).Conclusion Antidepressant adjuvant therapy improves the psychiatric symptoms of CP patients,which can effectively improve the clinical efficacy of antibiotic therapy of CP. Key words: Prostatitis; Paroxetine