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Fluoroquinolone-Macrolide Combination Therapy in Chronic Bacterial Prostatitis: Effect on Pathogen Eradication Rates, Inflammatory Findings and Sexual Dysfunction (CROSBI ID 578833)

Prilog sa skupa u zborniku | sažetak izlaganja sa skupa

Magri, V ; Montanari, E ; Škerk, Višnja ; Markotić, Alemka ; Marras, E ; Naber, K ; Perletti G Fluoroquinolone-Macrolide Combination Therapy in Chronic Bacterial Prostatitis: Effect on Pathogen Eradication Rates, Inflammatory Findings and Sexual Dysfunction // 3. hrvatski kongres o urogenitalnim i spolno prenosivim infekcijama s međunarodnim sudjelovanjem – Knjiga sažetaka / Škerk, Višnja (ur.). Zagreb, 2011. str. 50-51

Podaci o odgovornosti

Magri, V ; Montanari, E ; Škerk, Višnja ; Markotić, Alemka ; Marras, E ; Naber, K ; Perletti G

engleski

Fluoroquinolone-Macrolide Combination Therapy in Chronic Bacterial Prostatitis: Effect on Pathogen Eradication Rates, Inflammatory Findings and Sexual Dysfunction

Background: We previously demonstrated safety and efficacy of fluoroquinolone-macrolide combination therapy in cat. II (NIH-NIDDK) chronic bacterial prostatitis (CBP). Administration of this combination was characterized by a high safety profile, and was effective in eradicating both traditional uropathogens and unusual pathogens infecting the prostate gland. Moreover, a swift symptom decrease was observed in patients undergoing microbiological eradication. Interestingly, such combination decreased total serum PSA patients, thus markedly enhancing the cancer detection rate upon biopsy in a patient population. As patients found the original 6-week regimen lengthy and rather difficult to comply with, we investigated whether this therapeutic scheme could be modified to administer the same cumulative dose of 21 grams ciprofloxacin at the rate of 750 mg/day for 4 weeks. Objectives This study was aimed at comparing the microbiological, inflammatory, biochemical and clinical findings of two antibacterial treatment schemes for CBP, based on the combination of azithromycin (500 mg, thrice-weekly) with ciprofloxacin, administered at the once-daily doses of 500 mg (Cipro-500 cohort), or 750 mg (Cipro-750 cohort). The effect of combination therapy on sexual dysfunction, frequently observed in chronic prostatitis patients, was analyzed in detail. Findings Administration of the cumulative dose of 21 grams Ciprofloxacin at the rate of 750 mg/day for 4 weeks rather than at the rate of 500 mg/day for 6 weeks increased eradication rates from 62.3% to 77.3%, and the total bacteriological success from 71.8% to 85.6%. Relapse/reinfection rates were very low. A marked decrease of pain and voiding signs/symptoms was sustained throughout a 18-month follow-up period. Combination therapy also induced a significant reduction of inflammatory leukocyte counts and serum PSA, more pronounced in the Cipro-750 group. Ejaculatory pain, hemospermia and premature ejaculation were attenuated at microbiological eradication in both groups, but premature ejaculation symptoms subsided more promptly in the Cipro-750 cohort. Of total 59 Cipro-750 patients showing mild to severe erectile dysfunction (ED) at baseline, 22 had no ED at microbiological eradication and throughout a follow-up period of 18 months. Conclusions The results of this study add up to a growing body of data from our research group and from our Croatian partners, demonstrating that macrolides, in combination with first-line fluoroquinolones, are safe and effective in eradicating causative pathogens and in resolving a complex array of chronic bacterial prostatitis symptoms, including pain, voiding disturbances and sexual dysfunction.

Fluoroquinolone-Macrolide; Combination Therapy; Chronic Bacterial Prostatitis

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Podaci o prilogu

50-51.

2011.

objavljeno

Podaci o matičnoj publikaciji

3. hrvatski kongres o urogenitalnim i spolno prenosivim infekcijama s međunarodnim sudjelovanjem – Knjiga sažetaka

Škerk, Višnja

Zagreb:

Podaci o skupu

3. hrvatski kongres o urogenitalnim i spolno prenosivim infekcijama s međunarodnim sudjelovanjem

predavanje

20.05.2011-22.05.2011

Opatija, Hrvatska

Povezanost rada

Kliničke medicinske znanosti