engleski

Azithromycin and ciprofloxacin combination therapy in the treatment of chronic bacterial prostatitis caused by traditional pathogens

Objectives: Chronic bacterial prostatitis (CBP) is a chronic or persistent infection of the prostate in which a pathogen can be demonstrated by a lower urinary tract segmented localization test, but in which systemic symptoms are absent. CBP can be caused by traditional uropathogens - E. coli, P. mirabilis, Kl. pneumoniae, Ps. aeruginosa, unusual ; non-traditional uropathogens - C. trachomatis, U. urealyticum, and is also a biofilm disease. The aim of this study was to investigate the efficacy and tolerability of IV azithromycin and IV/PO ciprofloxacin combination therapy in the treatment of CBP caused by traditional uropathogens. Patients and Methods: The study was conducted at the UHID Department for Urogenital Infections between 2008 and 2010. We examined a total of 30 patients older than 20 years of age with CBP caused by traditional uropathogens. The patients were not consecutively enrolled. Ultrasound examination showed no evidence of anatomical abnormality of the genitourinary tract in these patients. During the first three consecutive days the patients received the following combination therapy: a total dose of 1, 5g azithromycin as a 3-day therapy of 1x500mg IV and a ciprofloxacin 400 mg IV bid. Ciprofloxacin 1x500 mg po bid was administered for additional 25 days. The severity of chronic prostatitis symptoms scored by the Croatian translation of the NIH-CPSI questionnaire was performed. Bacteriological and clinical efficacy, as well as tolerability and possible adverse events of administered drugs were evaluated 4-6 weeks and 6 months after completion of therapy. During the course of the study patients received no medication that would relieve their symptoms. Results: The frequency of detected pathogens in expressed prostatic secretion (EPS) was as follows: Enterococcus (9), E. coli (8), P. mirabilis (3), Kl. pneumoniae (3), Citrobacter (2), Enterobacter (2), Ps. aeruginosa (1), E. coli + Enterococcus (1), Ps. aeruginosa + Enterococcus (1). The eradication and clinical cure rates were 27/30 (90%) and 25/30 (83%), respectively, 4-6 weeks after completion of therapy and 24/30 (80%) and 23/30 (77%), 6 months after completion of therapy. There were no adverse events. Conclusion: The results of this research on the efficacy and tolerability of azithromycin IV and ciprofloxacin IV/PO combination therapy in the treatment of CBP are an additional confirmation that an improvement has been achieved in the clinical use of azithromycin for the treatment of CBP.

Azithromycin; ciprofloxacin; combination therapy; chronic bacterial prostatitis

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