Analysis of information sources in references of the Wikipedia article "Chronic bacterial prostatitis" in English language version.
Good to excellent penetration into prostatic fluid and tissue has been demonstrated with many antimicrobial agents, including tobramycin, netilmicin, tetracyclines, macrolides, quinolones, sulfonamides and nitrofurantoin. [...] Nitrofurantoin is a lipid-soluble weak acid with a pKa value that is somewhat favorable for diffusion into prostatic fluid [78]. Although low levels of nitrofurantoin were achieved in prostatic fluid in dogs, the administration of standard oral doses of this drug to men results in levels of ≤1 μg/ml of blood; such levels guarantee that the levels attained in prostatic fluid will be nontherapeutic.
We agree with guidelines [270] recommending fluoroquinolones, trimethoprim, and tetracyclines for treatment of chronic bacterial prostatitis, if the causative organism is susceptible. Emerging pharmacologic and clinical data also support the use of oral fosfomycin 3g every 2 days for 6–12 weeks for treatment of chronic bacterial prostatitis [256, 266, 271]. We avoid prescribing nitrofurantoin due to concerns of poor prostatic concentration [265].
Chronic oral antibiotic suppression for men with persistent or recurrent prostatic infections despite antibiotic treatment is frequently used in clinical practice, even though supporting data are presently lacking [2, 18]. This approach appears to be generally effective, so long as suppression can be maintained [17]. Suitable choices include nitrofurantoin, trimethoprim-sulfamethoxazole, methenamine, fluoroquinolones, cephalosporins, tetracyclines, or any agent previously effective for the isolated pathogen. [...] In our experience, many patients who previously struggled with symptomatic recurrences have been well controlled with chronic low-dose prophylaxis with methenamine combined with a vitamin C supplement. However, the long-term utility of prophylaxis with methenamine therapy is not well documented in the existing literature [60].
Nitrofurantoin prostatic levels are likely nontherapeutic.
The treatment of enterococcal prostatitis remains a challenge because of the paucity of antibiotics achieving both bactericidal effect and good prostatic diffusion. Indeed, prostatic concentrations of amoxicillin have not been consistently assessed, with concentrations varying from 0.77 to 26 μg/ml (2).
Patients with chronic prostatitis who gave positive culture results for anaerobes were treated with amoxicillin/clavulanic acid or clindamycin for 3-6 weeks. After treatment, samples were again taken and cultured for all pathogens known to cause prostatitis. These post-therapeutic samples revealed a decrease or total elimination of the symptoms, and no anaerobic bacteria could be detected.
Although penicillin derivatives have a reported role in the treatment of acute bacterial prostatitis, one study found that no patients treated with amoxicillin/clavulanic acid had resolution of their prostatitis [7,60].
In the NIH category II patients, there was no correlation between type of organism isolated or antibiotic used with response to therapy with the exception that no patient treated with [amoxicillin]–clavulonic acid had a complete and durable response.
Good to excellent penetration into prostatic fluid and tissue has been demonstrated with many antimicrobial agents, including tobramycin, netilmicin, tetracyclines, macrolides, quinolones, sulfonamides and nitrofurantoin. [...] Nitrofurantoin is a lipid-soluble weak acid with a pKa value that is somewhat favorable for diffusion into prostatic fluid [78]. Although low levels of nitrofurantoin were achieved in prostatic fluid in dogs, the administration of standard oral doses of this drug to men results in levels of ≤1 μg/ml of blood; such levels guarantee that the levels attained in prostatic fluid will be nontherapeutic.
We agree with guidelines [270] recommending fluoroquinolones, trimethoprim, and tetracyclines for treatment of chronic bacterial prostatitis, if the causative organism is susceptible. Emerging pharmacologic and clinical data also support the use of oral fosfomycin 3g every 2 days for 6–12 weeks for treatment of chronic bacterial prostatitis [256, 266, 271]. We avoid prescribing nitrofurantoin due to concerns of poor prostatic concentration [265].
Chronic oral antibiotic suppression for men with persistent or recurrent prostatic infections despite antibiotic treatment is frequently used in clinical practice, even though supporting data are presently lacking [2, 18]. This approach appears to be generally effective, so long as suppression can be maintained [17]. Suitable choices include nitrofurantoin, trimethoprim-sulfamethoxazole, methenamine, fluoroquinolones, cephalosporins, tetracyclines, or any agent previously effective for the isolated pathogen. [...] In our experience, many patients who previously struggled with symptomatic recurrences have been well controlled with chronic low-dose prophylaxis with methenamine combined with a vitamin C supplement. However, the long-term utility of prophylaxis with methenamine therapy is not well documented in the existing literature [60].
Nitrofurantoin prostatic levels are likely nontherapeutic.
The treatment of enterococcal prostatitis remains a challenge because of the paucity of antibiotics achieving both bactericidal effect and good prostatic diffusion. Indeed, prostatic concentrations of amoxicillin have not been consistently assessed, with concentrations varying from 0.77 to 26 μg/ml (2).
Amoxicillin-clavulanic acid (co-amoxiclav) and clindamycin. One case series included 50 men resistant to empirical treatment with quinolones. The expressed prostatic secretions from 24 of these men exhibited high colony counts of gram-positive and gram-negative anaerobic bacteria, either alone (18 men) or in combination with aerobic bacteria (6 men). After treatment with either amoxicillin-clavulanic acid or clindamycin for 3 to 6 weeks, all men had a decrease or total elimination of symptoms, and no anaerobic bacteria were detected in prostatic secretions.
Patients with chronic prostatitis who gave positive culture results for anaerobes were treated with amoxicillin/clavulanic acid or clindamycin for 3-6 weeks. After treatment, samples were again taken and cultured for all pathogens known to cause prostatitis. These post-therapeutic samples revealed a decrease or total elimination of the symptoms, and no anaerobic bacteria could be detected.
Although penicillin derivatives have a reported role in the treatment of acute bacterial prostatitis, one study found that no patients treated with amoxicillin/clavulanic acid had resolution of their prostatitis [7,60].
In the NIH category II patients, there was no correlation between type of organism isolated or antibiotic used with response to therapy with the exception that no patient treated with [amoxicillin]–clavulonic acid had a complete and durable response.
We agree with guidelines [270] recommending fluoroquinolones, trimethoprim, and tetracyclines for treatment of chronic bacterial prostatitis, if the causative organism is susceptible. Emerging pharmacologic and clinical data also support the use of oral fosfomycin 3g every 2 days for 6–12 weeks for treatment of chronic bacterial prostatitis [256, 266, 271]. We avoid prescribing nitrofurantoin due to concerns of poor prostatic concentration [265].
The treatment of enterococcal prostatitis remains a challenge because of the paucity of antibiotics achieving both bactericidal effect and good prostatic diffusion. Indeed, prostatic concentrations of amoxicillin have not been consistently assessed, with concentrations varying from 0.77 to 26 μg/ml (2).
Good to excellent penetration into prostatic fluid and tissue has been demonstrated with many antimicrobial agents, including tobramycin, netilmicin, tetracyclines, macrolides, quinolones, sulfonamides and nitrofurantoin. [...] Nitrofurantoin is a lipid-soluble weak acid with a pKa value that is somewhat favorable for diffusion into prostatic fluid [78]. Although low levels of nitrofurantoin were achieved in prostatic fluid in dogs, the administration of standard oral doses of this drug to men results in levels of ≤1 μg/ml of blood; such levels guarantee that the levels attained in prostatic fluid will be nontherapeutic.
Good to excellent penetration into prostatic fluid and tissue has been demonstrated with many antimicrobial agents, including tobramycin, netilmicin, tetracyclines, macrolides, quinolones, sulfonamides and nitrofurantoin. [...] Nitrofurantoin is a lipid-soluble weak acid with a pKa value that is somewhat favorable for diffusion into prostatic fluid [78]. Although low levels of nitrofurantoin were achieved in prostatic fluid in dogs, the administration of standard oral doses of this drug to men results in levels of ≤1 μg/ml of blood; such levels guarantee that the levels attained in prostatic fluid will be nontherapeutic.
