Pharmacokinetics of clarithromycin in the prostate: implications for the treatment of chronic abacterial prostatitis.
OBJECTIVE
We studied the pharmacokinetics of orally administered clarithromycin in prostatic tissue to define its role in the treatment of chronic abacterial prostatitis caused by intracellular pathogens.


METHODS
A total of 45 men receiving 3 oral doses of 750 mg. clarithromycin at 12-hour intervals underwent suprapubic prostatectomy for benign prostate hyperplasia 4, 5, 6 and 7 hours after the last drug dose in 13, 12, 10 and 10 patients, respectively. Concentrations were determined in the prostate tissue and in plasma by an agar diffusion assay.


RESULTS
A mean peak level of clarithromycin of 3.22 and 3.08 microg./gm. of tissue was achieved 4 hours after the third drug dose at the center and periphery of the adenoma, respectively. Tissue levels remained statistically superior to plasma levels at all intervals.


CONCLUSIONS
The oral administration of clarithromycin achieved a prostate level much higher than the minimal inhibitory concentration of clarithromycin for the intracellular pathogens of chronic prostatitis. Thus, clarithromycin may be considered for treating chronic abacterial prostatitis.
Giannopoulos
A
A
4th Department of Internal Medicine and 1st Department of Urology, University of Athens Medical School, Athens, Greece.
Koratzanis
G
G
Giamarellos-Bourboulis
E J
EJ
Panou
C
C
Adamakis
I
I
Giamarellou
H
H
D000284:Administration, Oral; D000368:Aged; D000900:Anti-Bacterial Agents / Q000493:pharmacokinetics* / Q000627:therapeutic use; D002908:Chronic Disease; D017291:Clarithromycin / Q000493:pharmacokinetics* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D011467:Prostate / Q000378:metabolism; D011468:Prostatectomy; D011470:Prostatic Hyperplasia / Q000601:surgery; D011472:Prostatitis / Q000188:drug therapy*; D013997:Time Factors; D014018:Tissue Distribution
D000900:Anti-Bacterial Agents; D017291:Clarithromycin