title: Efficacy of repeated cycles of combination therapy for the eradication of infecting organisms in chronic bacterial prostatitis.
abstract: A total of 137 patients with a diagnosis of chronic bacterial prostatitis (CBP) were subjected to combination pharmacological therapy with antibacterial agents (ciprofloxacin/azithromycin), alpha-blockers (alfuzosin) and Serenoa repens extracts. Of those, 88 patients (64.2%) showed microbiological eradication at the completion of a 6-week cycle of therapy. Of the remaining 49 patients showing persistence of the causative organism(s) or reinfection at the end of treatment, 36 completed a second cycle of combination therapy for 6 weeks: 27 patients (75%) showed eradication of the causative organism, whereas in nine cases persistence or reinfection was observed. The cumulative eradication rate of the present study - calculated on a total of 137 enrolled patients - is 83.9%. Clinical examination showed a marked improvement of signs and symptoms linked to prostatitis. Remarkably, combination therapy could attenuate CBP symptoms prior to microbiological eradication, thus rapidly decreasing the impact of the disease on the quality of life of patients. Clinical remission was extended throughout a follow-up period of 30 months for 94% of patients, whereas seven patients showed relapse of the disease. In summary, our results indicate that about 20% of patients enrolled in this study, who were refractory to a protocol of 6-week combination therapy, could be 'rescued' by a second cycle of treatment. Clinical follow-up data show that combination therapy could ensure extended relief from CBP symptoms, and a general improvement in quality of life.
authors.affiliation: Urology and Sonography Outpatient Clinic, Istituti Clinici di Perfezionamento, Milan, Italy.
authors.forename: Vittorio
authors.initials: V
authors.lastname: Magri
authors.forename: Alberto
authors.initials: A
authors.lastname: Trinchieri
authors.forename: Giacomo
authors.initials: G
authors.lastname: Pozzi
authors.forename: Antonella
authors.initials: A
authors.lastname: Restelli
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Garlaschi
authors.forename: Erminio
authors.initials: E
authors.lastname: Torresani
authors.forename: Pasquale
authors.initials: P
authors.lastname: Zirpoli
authors.forename: Emanuela
authors.initials: E
authors.lastname: Marras
authors.forename: Gianpaolo
authors.initials: G
authors.lastname: Perletti
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology / Q000652:urine; D002908:Chronic Disease; D004338:Drug Combinations; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D011472:Prostatitis / Q000188:drug therapy* / Q000382:microbiology / Q000652:urine; D012008:Recurrence; D013094:Spermatozoa / Q000382:microbiology; D014521:Urethra / Q000382:microbiology; D014563:Urodynamics / Q000502:physiology
chemical_list: D000900:Anti-Bacterial Agents; D004338:Drug Combinations