Eficácia clínica da antibioterapia na prostatite crónica por microrganismos resistentes aos antibióticos de primeira linha

• Autor(a) principal: Ana Catarina Moreira dos Santos Andrade
• Data de Publicação: 2018
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://hdl.handle.net/10216/114299
• topic: Medicina clínica; Clinical medicine

INTRODUCTION: Chronic bacterial prostatitis (CBP) accounts for 5-10% of all prostatitis cases, inducing a significant decline in the quality of life of these patients. The current therapeutic approach of CBP is based on long-term antibacterial therapy with fluoroquinolones. However, many cases relapse with gained antibiotic resistance, requiring another cycle of antibiotic, sometimes intravenous in inpatient care setting. This paper presents a review of the literature on the efficacy of oral antibiotics in the treatment of CBP by microorganisms resistant to first-line antibiotics. MATERIALS AND METHODS: Review of the literature published in PubMed, using the keywords: "prostatitis", "nitrofurantoin", "macrolides", "fosfomycin", "amoxicilin", "cephalosporins", "tetracycline" and "doxycycline". RESULTS: 15 studies were included, which analyzed the clinical (clinical cure) and/or microbiological efficacy (bacterial eradication) in men with CBP caused by various etiological agents treated with fosfomycin, amoxicillin, macrolides and tetracyclines DISCUSSION: In two case series, fosfomycin and amoxicillin-clavulanic acid combination showed good results in the treatment of CBP by multidrugresistant Enterobacteriaceae, hence they may be a therapeutic alternative for these cases. Most of the research on the role of macrolides and tetracyclines in CBP is focused at intracellular atypical agents, and it has been concluded that these two classes should be the first choice in this etiology. In CBP caused by traditional etiologic agents, studies show that the fluoroquinolone-macrolide combination is effective. CONCLUSION: Given the need for new alternatives to fluoroquinolones for treatment of resistant CBP, further studies are necessary in this area.