Treatment Of Chronic Bacterial Prostatitis Research Articles

Fabrication and application of targeted ciprofloxacin nanocarriers for the treatment of chronic bacterial prostatitis

Pathogenic bacteria cause chronic bacterial prostatitis (CBP). CPB is characterized by urinary tract infection and persistence of pathogenic bacteria in prostatic secretion. Owing to poor blood supply to the prostate gland and limited drug penetration, CBP treatment is difficult. Transferosomes are ultradeformable vesicles for nanocarrier applications, which have become an important area of nanomedicine. Such carriers are specifically targeted to the pathological area to provide maximum therapeutic efficacy. It consists of a lipid bilayer soybean lecithin phosphatidylcholine (PC), an edge activator Tween 80 with various ratios, and a chloroform/methanol core. Depending on the lipophilicity of the active substance, it can be encapsulated within the core or among the lipid bilayer. Due to their exceptional flexibility, which enables them to squeeze themselves through narrow pores that are significantly smaller than their size, they can be a solution. One formulation (Cipro5 PEG) was selected for further in vitro analysis and was composed of phosphatidylcholine (PC), Tween 80, and polyethylene glycol-6 stearate (PEG-6 stearate) in a ratio of 3:3:1 in a chloroform/methanol mixture (1:2 v/v). In vitro, the results showed that PEGylated transferosomes had faster drug release, higher permeation, and increased bioavailability. The transferosomes were quantified with a particle size of 202.59 nm, a zeta potential of-49.38 mV, and a drug entrapment efficiency of 80.05%. The aim of this study was to investigate drug targeting. Therefore, Monoclonal antibody IgG was coupled with Cipro5 PEG, which has specificity and selectivity for conjugated nanoparticles. In vivo, a total of twenty-five adult Wistar rats were obtained and randomly divided into 5 groups, each of 5 rats at random: the control group, blank group, positive control group, Cipro 5PEG group, and Cipro 5PEG coupled with IgG antibody group. The cytokines levels (IL-1β, IL-8, and TNF-α) in the serum were detected by analysis kits. Compared with the control group, treatment with Cipro 5PEG coupled with the IgG antibody could significantly inhibit cytokines, according to histological analysis. Cipro 5PEG, coupled with the IgG antibody group, reduced prostate tissue inflammation. Hence, our results show a promising approach to delivering antibiotics for the targeted therapy of CBP.

Effectiveness of Wobenzym in combined therapy of chronic bacterial prostatitis. Results of systematic review and meta-analysis

A systematic review and meta-analysis of research data on the effectiveness of the drug Wobenzym in the treatment of chronic bacterial prostatitis was performed. The aim of this study to evaluate the effectiveness of Wobenzym in the complex therapy of chronic bacterial prostatitis. The analysis included randomized and non-randomized controlled studies of the effectiveness of Wobenzim in the complex therapy of chronic bacterial prostatitis. The search was carried out in the databases CENTRAL, PubMed, ICTRP, eLibrary, ClinicalTrials.gov., Google Scholar, CyberLeninka, search engines. The meta-analysis was conducted using the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions. Statistical heterogeneity was assessed using the Cochran test and visually when constructing forest plots. A random effects model and a fixed effect model were used. Works published over the entire period were analyzed, 712 publications were identified, of which 9 fully met the stated criteria, all studies were non-randomized controlled. The final analysis included the results of 1292 patients. According to the meta-analysis, it was possible to establish the superiority of complex therapy including Wobenzym compared to therapy without Wobenzym in all studied parameters: eradication of the pathogen, decrease in the number of points on the Quality of Life (QoL) scale, an increase in the linear speed of blood flow in the veins and peak systolic blood flow velocity in the arteries of the prostate gland, maximum urine flow rate, reduction in the number of points of the NIH-CPSI “Pain” subscale (difference 5 points) and NIH-CPSI “Quality of Life” subscale. The use of therapy including Wobenzym in patients with chronic prostatitis leads to a greater increase in the number of CD4+, CD8+ lymphocytes, phagocytic activity of lymphocytes, the level of complement CH-100 and immunoglobulins M, G, A. A systematic review/meta-analysis revealed an objective, statistically significant, positive effect of the drug Wobenzym in the complex therapy of patients with chronic bacterial prostatitis, which is associated with its pathogenetic orientation in relation to this group of patients.

Prospects of oral fosfomycin for the treatment of chronic bacterial prostatitis

The most frequent causative agent of chronic bacterial prostatitis is Escherichia coli, however, in recent years, the proportion of other gram-negative and gram-positive microorganisms in the structure of pathogens has been increasing. There is not only an increase in the proportion of extended-spectrum β-lactamases producing Escherichia coli, which ensures the resistance of bacteria to penicillins, cephalosporins and aztreonam, but also carbapenemases producing strains. The tendency of increasing resistance of uropathogens to fluoroquinolones is noted. An alternative for the treatment of bacterial prostatitis may be fosfomycin, which is due to its high bioavailability when taken orally and the ability to reach high concentrations in the prostate.This review examines the mechanisms of action of fosfomycin, the features of its pharmacokinetics in the prostate gland, the antimicrobial spectrum and the mechanisms of resistance to fosfomycin of uropathogens. The results of oral fosfomycin for the treatment of chronic bacterial prostatitis are discussed.

The Efficacy of Flogofilm® in the Treatment of Chronic Bacterial Prostatitis as an Adjuvant to Antibiotic Therapy: A Randomized Prospective Trial.

Bacterial prostatitis (BP) is a common prostatic infection characterized by a bimodal distribution in young and older men, with a prevalence between 5-10% among all cases of prostatitis and a high impact on quality of life. Although the management of bacterial prostatitis involves the use of appropriate spectrum antibiotics, which represent the first choice of treatment, a multimodal approach encompassing antibiotics and nutraceutical products in order to improve the efficacy of chosen antimicrobial regimen is often required. To evaluate the efficacy of Flogofilm® in association with fluoroquinolones in patients with chronic bacterial prostatitis (CBP). Patients diagnosed with prostatitis (positivity to Meares-Stamey Test and symptoms duration > 3 months) at the University of Naples "Federico II", Italy, from July 2021 to December 2021, were included in this study. All patients underwent bacterial cultures and trans-rectal ultrasounds. Patients were randomized into two groups (A and B) receiving antibiotic alone or an association of antibiotics plus Flogofilm® tablets containing Flogomicina® for one month, respectively. The NIH-CPSI and IPSS questionnaires were administered at baseline, four weeks, twelve and twenty-four weeks. A total of 96 (Group A = 47, Group B = 49) patients concluded the study protocol. The mean age was comparable, with a mean age of 34.62 ± 9.04 years for Group A and 35.29 ± 10.32 years for Group B (p = 0.755), and IPSS at the baseline was 8.28 ± 6.33 and 9.88 ± 6.89 (p = 0.256), respectively, while NIH-CPSI at baseline was 21.70 ± 4.38 and 21.67 ± 6.06 (p = 0.959), respectively. At 1, 3 and 6 months, the IPSS score was 6.45 ± 4.8 versus 4.31 ± 4.35 (p = 0.020), 5.32 ± 4.63 versus 3.20 ± 3.05 (p = 0.042) and 4.91 ± 4.47 versus 2.63 ± 3.28 (p = 0.005) for Groups A and B, respectively. Similarly, the NIH-CPSI total score at 1, 3 and 6 months was 16.15 ± 3.31 versus 13.10 ± 5.03 (p < 0.0001), 13.47 ± 3.07 versus 9.65 ± 4.23 (p < 0.0001) and 9.83 ± 2.53 versus 5.51 ± 2.84 (p < 0.0001), respectively. Flogofilm®, associated with fluoroquinolones, demonstrate a significant improvement in pain, urinary symptoms and quality of life in patients affected by chronic bacterial prostatitis in both IPSS and NIH-CPSI scores compared with fluoroquinolones alone.

Complex treatment of patients with chronic bacterial prostatitis using biologically active peptides

BACKGROUND: Increasing the effectiveness of the treatment of chronic bacterial prostatitis is an actual problem of modern urology.&#x0D; AIM: The aim of the study was to study the effectiveness of complex treatment of patients with chronic bacterial prostatitis using Prostatex.&#x0D; MATERIALS AND METHODS: This study included 94 patients with chronic bacterial prostatitis aged 21 to 45 years. Patients of group I (n = 47) received standard antibiotic therapy (levofloxacin at a dose of 500 mg 2 times a day for 28 days), and patients of group II (n = 47) received standard antibiotic therapy combined with the prescription of Prostatex in the form of rectal suppositories 10 mg once a day.&#x0D; RESULTS: The overall clinical efficacy of treatment in patients of group II was 2 times higher than in patients of group I. After treatment in patients of group II compared with group I a statistically significant decrease in chronic bacterial prostatitis symptoms according to the NIH-CPSI and IPSS questionnaires was recorded. Eradication of microflora in 91.4% of patients of group II was achieved, there was a significant decrease in prostate volume, an increase in the average volumetric flow rate of urine by 89.8%, normalization of perfusion parameters and the index of microcirculation efficiency.&#x0D; CONCLUSIONS: The results of the study showed that the use of Prostatex in the complex treatment of chronic bacterial prostatitis patients has a positive effect on the main symptoms of chronic prostatitis, significantly reducing pain, urination disorders and improving sexual function. This therapy helps to reduce the volume of the prostate and the volume of residual urine, restores microcirculation in the prostate gland and can be recommended in this category of patients.

Современные подходы к лечению хронического бактериального простатита.

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.

Antibiotic-loaded reactive oxygen species-responsive nanomedicine for effective management of chronic bacterial prostatitis

Chronic bacterial prostatitis (CBP) occurs frequently in the male population and significantly influences quality of life. Antibiotics are the main strategy for managing chronic bacterial prostatitis; however, most antibiotics have low efficacy due to their poor penetration of prostate tissues. To overcome this challenge, we fabricated cefpodoxime proxetil (CPD)-loaded reactive oxygen species (ROS)-responsive nanoparticles (NPs) for targeted treatment of CBP. These NPs were modified with folic acid (FA) and could be effectively internalized by bacteria-infected macrophages and prostatic epithelial cells because of the high expression of folate receptors (FRs) in these cells. In vitro cellular assays demonstrated that the CPD-loaded nanomedicine can obviously reduce proinflammatory cytokine expression in cells since the nanomedicine can efficiently eradicate cellular bacteria. In vivo imaging results verified that FA-modified nanomedicines can penetrate the prostatic epithelium and accumulate in the glandular lumen because FRs overexpression was also observed in the prostate tissues of CBP mice. Animal experiments demonstrated that FA-modified nanomedicine can remarkably relieve pelvic pain in CBP mice and dramatically decrease proinflammatory cytokine expression in prostate tissues via eradication of bacteria and scavenging of ROS. Our results provide a new strategy to deliver antibiotics for targeted therapy of CBP. Statement of significanceTo overcome poor penetration of antibiotics in prostatic tissues, we developed an antibiotics-loaded ROS-responsive NPs for targeted treatment of CBP. We demonstrated that both bacteria-infected macrophages and prostatic epithelial cells have FRs overexpression, thus FA-modified NPs can be efficiently internalized by these cells. FA-modified NPs can penetrate the prostatic epithelium and accumulate in the glandular lumen via FRs-mediated endocytosis, and the accumulated NPs can smartly release their payload under high ROS microenvironment. A distinguished therapy outcome was obtained in murine CBP model since CPD-loaded NPs can efficiently eradicate the resident bacteria in prostate tissues and downregulate proinflammatory cytokine expression. Our work provides a practicable strategy to expand the application of antibiotics for management of CBP.

Ceftriaxone for the Treatment of Chronic Bacterial Prostatitis: A Case Series and Literature Review.

Chronic bacterial prostatitis is increasingly difficult to treat due to rising antimicrobial resistance limiting oral treatment options. In this case series, 11 men with CBP (including patients with urological comorbidities) due to multi-resistant E. coli were treated with once-daily ceftriaxone intravenously for 6 weeks. Nine patients were clinically cured at 3 months follow up. No early withdrawal of medication due to side effects occurred. A literature review was conducted to describe the prostate pharmacokinetics of ceftriaxone and its use in prostatic infection. In conclusion, ceftriaxone can be considered an appropriate treatment of chronic bacterial prostatitis.

Antibiotic therapy of chronic bacterial prostatitis is more effective considering antibiotic susceptibility of all pathogens isolated

PurposeBecause of the insufficient efficacy of the current treatment of chronic bacterial prostatitis (CBP), it is justified to search for a more effective antibiotic therapy (ABT).Materials and MethodsThis single-centre prospective observational comparative study was conducted in 2012 to 2019 (patients: 60 men with CBP; age: 20–45 y). The clinical examination was performed on admission and at 1, 3, 6, or 12 months. All patients underwent the Meares–Stamey test to obtain expressed prostatic secretion (EPS) and/or post-massage urine (PMU) samples for extended bacteriological examination. The patients were randomly divided into 2 treatment groups (30/30 patients): group I, fluoroquinolones (FQs); group II, a combination of FQs with cephalosporins/macrolides with a treatment duration of 1 month.ResultsPatients of both groups had severe symptomatic CBP with an average duration of 4 years. Twenty-three microorganisms (15 aerobes, 9 anaerobes) were identified in PMU. At 3 months follow-up, a positive clinical effect was noted in both groups, which was significant (p<0.05) only in group II concerning NIH-CPSI questionnaire, leukocyturia, prostate volume, maximum urine flow, and decreased pathospermia. At 6 months follow-up, in group II the frequency of Escherichia coli and Enterococcus spp. decreased significantly. In group I aerobes changed only insignificantly from the initial level, but anaerobes increased significantly. In group II the titers of both, aerobes and anaerobes, were significantly lower (p<0.05) at 6 months follow-up as compared to initial values.ConclusionsABT targeting all taxa in EPS/PMU is a more effective alternative to standard therapeutic regimens for CBP.

Dihydroartemisinin Promoted Bone Marrow Mesenchymal Stem Cell Homing and Suppressed Inflammation and Oxidative Stress against Prostate Injury in Chronic Bacterial Prostatitis Mice Model.

Although bone marrow mesenchymal stem cells (BMMSCs) are effective in treating chronic bacterial prostatitis (CBP), the homing of BMMSCs seems to require ultrasound induction. Dihydroartemisinin (DHA) is an important derivative of artemisinin (ART) and has been previously reported to alleviate inflammation and autoimmune diseases. But the effect of DHA on chronic prostatitis (CP) is still unclear. This study aims to clarify the efficacy and mechanism of DHA in the treatment of CBP and its effect on the accumulation of BMMSCs. The experimental CBP was produced in C57BL/6 male mice via intraurethrally administered E. coli solution. Results showed that DHA treatment concentration-dependently promoted the accumulation of BMMSCs in prostate tissue of CBP mice. In addition, DHA and BMMSCs cotreatment significantly alleviated inflammation and improved prostate damage by decreasing the expression of proinflammatory factors such as TNF-α, IL-1β, and chemokines CXCL2, CXCL9, CXCL10, and CXCL11 in prostate tissue of CBP mice. Moreover, DHA and BMMSCs cotreatment displayed antioxidation property by increasing the production of glutathione peroxidase (GSH-Px), SOD, and decreasing malondialdehyde (MDA) expression. Mechanically, DHA and BMMSCs cotreatment significantly inhibited the expression of TGFβ-RI, TGFβ-RII, phosphor (p)-Smad2/3, and Smad4 in a dose-dependent manner while stimulated Smad7 expression in the same manner. In conclusion, our findings provided evidence that DHA effectively eliminated inflammatory and oxidative stress against prostate injury, and this effect involved the TGF-β/Smad signaling pathway in CBP.

Analysis of the Effectiveness of Various Types of Conservative Therapy for Chronic Bacterial Prostatitis

Analysis of the Effectiveness of Various Types of Conservative Therapy for Chronic Bacterial Prostatitis

MP35-03 INDICATIONS AND OUTCOMES OF SURGICAL TREATMENT FOR CHRONIC BACTERIAL PROSTATITIS IN A CONTEMPORARY CASE SERIES

You have accessJournal of UrologyInfections/Inflammation/Cystic Disease of the Genitourinary Tract: Prostate & Genitalia (MP35)1 Sep 2021MP35-03 INDICATIONS AND OUTCOMES OF SURGICAL TREATMENT FOR CHRONIC BACTERIAL PROSTATITIS IN A CONTEMPORARY CASE SERIES Johnathan Doolittle, and Daniel Shoskes Johnathan DoolittleJohnathan Doolittle More articles by this author , and Daniel ShoskesDaniel Shoskes More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002044.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Category II prostatitis or Chronic Bacterial Prostatitis (CBP) is characterized by recurrent bacterial urinary tract infections with a prostatic source. While antibiotics are the treatment of choice, infection may not be cured in at least 40% and surgery might be necessary. Indications for surgery and outcomes, vary widely in the literature. Our objective was to study our case series of surgery for CBP focused on indications and outcomes. METHODS: We retrospectively identified all patients undergoing surgical treatment for CBP managed by a single provider over the past decade. Pre-surgical variables included presence of recurrent infections, bacterial species, TRUS volume, presence of prostate stones, localizing prostatic cultures, and surgical treatment. Transurethral surgery was offered to patients with prostatic stones within the surgical capsule, and total prostatectomy to those with prostate cancer or nidus not manageable with TUR. Surgery therapy, outcome, complications and follow up were recorded. RESULTS: 19 patients with a mean age of 67.2 years underwent surgery from 2010 through 2019. Relevant pre and post-operative data for each of the 19 patients is reported in Table 1. All patients had documented recurrent infections despite antibiotics. Average TRUS volume was 45.6cc, stones were identified in 8/19 patients, and prostate cancer was diagnosed in 3 of the 5 patients that underwent pre-operative biopsy. 12 patients underwent TURP and 7 total prostatectomy (TP) with a cure rate for infections of 84.2% (16/19) and a mean follow up of 36.9 months. 4/19 patients experienced long term complications from treatment, including 3/7 patients after TP. One of 12 TURP patients developed a urethral stricture post operatively. CONCLUSIONS: Careful patient selection for surgical treatment of CBP with identifiable prostatic localization of a surgical target or concomitant cancer resulted in a 84.2% cure rate in our series with over 3 year follow up. While TURP is seldom effective as a cure all for “prostatitis”, careful patient selection can lead to a high bacteriologic cure rate. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e627-e627 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Johnathan Doolittle More articles by this author Daniel Shoskes More articles by this author Expand All Advertisement Loading ...

Eficácia Clínica da Antibioterapia na Prostatite Crónica por Microrganismos Resistentes aos Antibióticos de Primeira Linha

Introdução: Métodos: Resultados: Discussão: Conclusão: A prostatite crónica bacteriana corresponde a 5% - 10% dos casos de prostatite crónica, sendo responsável porum declínio significativo na qualidade de vida destes doentes. A abordagem terapêutica atual da prostatite crónica bacteriana baseia-se em antibioterapia de longa duração com fluoroquinolonas. Contudo, muitos destes casos recidivam com resistência e requerem antibioterapia, por vezes por via parentérica, em regime de internamento. Este trabalho apresenta uma revisão da literatura relativa à eficácia de alguns antibióticos, por via oral, no tratamento da prostatite crónica bacteriana por microrganismos resistentes aos antibióticos de primeira linha. Métodos: Revisão da literatura, seguindo a metodologia PICO, através da PubMed, utilizando como palavras-chave: “prostatitis”, “nitrofurantoin”, “macrolides”, “fosfomycin”, “amoxicillin”, “cephalosporins”, “tetracycline” e “doxycycline”. Resultados: Foram incluídos 15 estudos que avaliaram a eficácia clínica (cura clínica) e/ou microbiológica (erradicação bacteriana) em homens com prostatite crónica bacteriana por diversos agentes etiológicos tratados com fosfomicina, amoxicilina, macrólidos ou tetraciclinas. E Discussão: Em duas séries de casos publicadas, a fosfomicina e a combinação amoxicilina-ácido clavulânico apresentaram eficácia parcial na prostatite crónica bacteriana por Enterobacteriáceas multirresistentes. A combinação fluoroquinolona-macrólido revelou-se também muito eficaz na prostatite por agentes etiológicos tradicionais. A maioria da investigação sobre o papel dos macrólidos e tetraciclinas na prostatite crónica bacteriana está direcionada para agentes atípicos intracelulares, sendo de primeira escolha nesta etiologia. Conclusão: Dada a necessidade de novas alternativas para o tratamento da prostatite crónica bacteriana resistente, são precisos mais estudos nesta área.

Chronic bacterial prostatitis associated with androgen deficiency

Inflammation of the prostate gland occupies a significant proportion of inflammatory diseases of the genitourinary system. According to J.Potts et al. (2007), prostatitis is detected in 510% of the general male population. Today, one of the main problems associated with prostatitis is the narrowly targeted, often unwarranted treatment with its antibacterial drugs without taking into account the multifactorial nature of the pathogenesis and androgen dependence of the prostate gland. As a result, this leads to ineffective treatment of prostatitis amid growing antibiotic resistance. In turn, recent studies demonstrate key issues of testosterone and prostate gland relationship. These researches show that prostate metabolism is dependent on testosterone levels. The level of the hormone affects the course of chronic inflammation in the prostatic tissues. And also, that the number of bacterial agents that provoke pathological processes in the prostatic parenchyma directly depends on the degree of decrease in testosterone levels. This point of view is also supported by other studies. It was found that most patients with inflammation of the prostate gland had androgen deficiency, and correction of testosterone levels of these patients was highly effective in the treatment of chronic prostatitis. Thus, the androgen dependence of the prostate gland and the effect of hypogonadism on the incidence of prostatic parenchymal inflammatory changes allow us to radically revise the approach to the diagnosis and treatment of chronic bacterial prostatitis. The development and implementation of new algorithms in which the diagnosis and subsequent correction of concomitant androgenic are becoming a promising direction for this group of patients.

Трансректальная озоно- и магнитотерапия в лечении хронического бактериального простатита

To evaluate the efficiency of combined transrectal ozone and magnetic therapy for the treatment of chronic bacterial prostatitis (CBP). A total of 142 men with CBP were included in the study and allocated to different treatment, including standard therapy for 6 weeks (n=40), transrectal magnetic therapy in addition to standard therapy (n=35), transrectal ozone therapy in addition to standard therapy (n=37), transrectal magnetic and ozone therapy in addition to standard therapy (n=30). Treatment results were evaluated 3 months after the completion of therapy. The most pronounced positive improvement in all evaluated parameters was observed among patients who received both magnetic and ozone therapy, according to the criteria of all domains of the NIH-CPSI questionnaire, IIEF-5 questionnaire, and based on the changes in prostate volume, maximum urination rate, residual urine volume and microscopic examination of prostate secretion. To achieve optimal results in the treatment of CBP, it is necessary to use both consequently magnetic and ozone therapy, in addition to standard therapy.

ASSESSMENT OF THE EFFICIENCY OF THE APPLICATION OF THE COWBERRY AND BLUEBARRY PASTE IN COMPLEX TREATMENT OF CHRONIC BACTERIAL PROSTATITIS

In order to evaluate the eff ectiveness of cowberry and blueberry pastes in the complex treatment of chronic bacterial prostatitis, 72 patients of the Men’s Health clinic in Kyiv were examined. According to the survey results, 2 symmetric groups of 23 patients were formed. The main group was treated according to the model: antibiotic therapy, auxiliary pharmacotherapy (venotonic drugs and enzymes), local physiotherapy and diet therapy with the inclusion of cowberry and blueberry pastes. The control group received a similar treatment, but without changing the diet.Evaluating the eff ectiveness of cowberry and blueberry pastes in the complex treatment of chronic bacterial prostatitis shows that patients treated with the inclusion of homogenized cowberry and blueberry pastes in the diet demonstrate a lower intensity of symptoms of chronic bacterial prostatitis (according to the I-PSS scale) 3 months after treatment, namely: “urination urgency” and “subjective reduction in the quality of life” (p=0.03).

Usage and Dosage of Fosfomycin for NIH Category II Chronic Bacterial Prostatitis

Chronic bacterial prostatitis (CBP, NIH category II) is a difficult- to-eradicate, recurring, chronic infection of the prostate, often characterized by disabling symptoms, significantly reducing the quality of life of patients. Fluoroquinolones have been for many years first-line agents for treatment of this condition. However, mounting pathogen resistance trends (especially in Mediterranean countries like Greece and Italy) are progressively restricting the usage of fluoroquinolones for treating many Gram-positive or Gram-negative infections in the urological field, and clinicians are increasingly treating bacterial prostatitis by empirically administering agents which have not been adequately tested in the frame of clinical trials. In recent years, reports on the efficacy of the bactericidal antibiotic fosfomycin on CBP have been published. Most articles published so far are case reports, and only few case series or cohort studies are available. The aim of this article is to review the information published so far concerning the usage and dosage of fosfomycin for treatment of chronic bacterial prostatitis.

93 - The role of next generation sequencing of semen samples in the diagnosis and treatment of chronic bacterial prostatitis

93 - The role of next generation sequencing of semen samples in the diagnosis and treatment of chronic bacterial prostatitis

Oral fosfomycin for the treatment of chronic bacterial prostatitis

BackgroundChronic bacterial prostatitis (CBP) is a difficult-to-treat infection as only a few antibiotics achieve therapeutic concentrations in the prostate. Data on the efficacy and safety of oral fosfomycin for the treatment of CBP are limited.ObjectivesTo analyse the efficacy and safety of fosfomycin in CBP due to MDR pathogens.MethodsIn a prospective observational study, an oral regimen of 3 g of fosfomycin q24h for 1 week followed by 3 g q48h for a treatment duration of 6–12 weeks was administered. The outcome was clinical and microbiological cure rate at the end of treatment (EOT) and rate of relapse at 3 and 6 months.ResultsThe study included 44 patients. The most common pathogen was Escherichia coli (66%), followed by Klebsiella spp. (14%) and Enterococcus faecalis (14%). Most strains were MDR (59%) and 23% had an ESBL phenotype; 33 of 44 strains were resistant to fluoroquinolones, but all were susceptible to fosfomycin (median MIC for Gram-negative pathogens 1.5 mg/L). In 25 patients, treatment was administered for 6 weeks, whereas in the remaining 19 patients it was prolonged to 12 weeks based on the presence of calcifications in the prostate. Cure rate was 82% at EOT and 80% and 73% at 3 and 6 months accordingly. Microbiological eradication was achieved in 86% and 77% at EOT and at 6 months, respectively. Failure was observed in 12 patients. The most common adverse event was diarrhoea (18%).ConclusionsOral fosfomycin, particularly in the era of MDR prevalence, represents an attractive, safe and effective alternative to fluoroquinolones for the treatment of CBP.

The use of drugs Laferomaks and Prosteks in treatment of chronic bacterial prostatitis, combined with benign prostatic hyperplasia

The use of drugs Laferomaks and Prosteks in treatment of chronic bacterial prostatitis, combined with benign prostatic hyperplasia