Clinical Efficacy of Antibiotherapy in Chronic Prostatitis by Microorganisms Resistant to First-Line Antibiotics

• Autor(a) principal: Andrade, Ana Catarina
• Data de Publicação: 2020
• Outros Autores: Figueiredo, Luís Pacheco, Dinis, Paulo
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://doi.org/10.24915/aup.37.1-2.85
• topic: Anti-Bacterial Agents/therapeutic use; Drug Resistance, Multiple, Bacterial; Prostatitis/drug therapy; Antibacterianos/uso terapêutico; Farmacorresistência Bacteriana Múltipla; Prostatite crónica/tratamento farmacológico

Introduction: Chronic bacterial prostatitis accounts for 5% - 10% of all prostatitis cases, inducing a significant decline in the quality of life of patients. The current therapeutic approach of chronic bacterial prostatitis is based on long-term antibacterial therapy with fluoroquinolones. However, many cases relapse with gained antibiotic resistance, requiring another treatment cycle, sometimes intravenous in inpatient care setting. This paper presents a review of the literature on the efficacy of oral antibiotics in the treatment of chronic bacterial prostatitis by microorganisms resistant to first-line antibiotics. Methods: Systematic review according to PICO methodology of the literature published in PubMed, using the keywords: “prostatitis”, “nitrofurantoin”, “macrolides”, “fosfomycin”, “amoxicillin”, “cephalosporins”, “tetracycline” and “doxycycline”. Results: 15 studies were included, which analyzed the clinical (clinical cure) and/or microbiological efficacy (bacterial eradication) in men with chronic bacterial prostatitis caused by various etiological agents treated with fosfomycin, amoxicillin, macrolides or tetracyclines. Discussion: In two case series, fosfomycin and amoxicillin-clavulanic acid combination showed efficacy in chronic bacterial prostatitis by multidrugresistant Enterobacteriaceae, hence they may be a therapeutic alternative. A fluoroquinolone-macrolide combination was also effective in chronic bacterial prostatitis caused by habitual bacterial agents. Good quality studies exist on the role of macrolides and tetracyclines in chronic bacterial prostatitis caused by intracellular atypical agents, where they present as first choice. Conclusion: The need for new alternatives in the treatment of resistant chronic bacterial prostatitis and the paucity of available information, warrant further research in this area.