title: Clinical and Microbiological Features and Factors Associated with Fluoroquinolone Resistance in Men with Community-Acquired Acute Bacterial Prostatitis.
abstract: OBJECTIVE
  To investigate the clinical and microbiological features in the patients with community-acquired acute bacterial prostatitis (CA-ABP), as well as factors that affect fluoroquinolone resistance.
  
  
  METHODS
  A retrospective analysis was performed of 209 patients hospitalized for antibiotic treatment of CA-ABP. We investigated patient age, body mass index, underlying diseases, recurrence, prostate-related factors and results of urine culture examination and antibiotic sensitivity tests.
  
  
  RESULTS
  Seventeen patients (8.1%) had fluoroquinolone-resistant bacterial colonies. When we divided the subjects into groups according to the fluoroquinolone resistance, the group with resistant bacteria was significantly older, had larger prostates and had greater residual urine volumes. Bacteria were identified in 127 of 209 patients (60.8%), and the most commonly cultured included Escherichia coli (43.5%). The sensitivity of the cultured bacteria to fluoroquinolones was high compared to trimethoprim/sulfamethoxazole and gentamicin, but similar to cefotaxime. The bacteria were more sensitive to amikacin and imipenem than to fluoroquinolone. The multivariate analysis revealed that prostate volume ≥40 ml (p = 0.024) and residual urine volume >100 ml (p = 0.004) were independent predictive factors for fluoroquinolone resistance.
  
  
  CONCLUSIONS
  Fluoroquinolone monotherapy might be an effective treatment in CA-ABP. However, combination antibiotic therapy is recommended in cases with prostate volume ≥40 ml or residual urine volume >100 ml, because fluoroquinolone resistance can occur.
authors.affiliation: Department of Urology, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea.
authors.forename: Min Gu
authors.initials: MG
authors.lastname: Park
authors.forename: Min Chul
authors.initials: MC
authors.lastname: Cho
authors.forename: Sung Yong
authors.initials: SY
authors.lastname: Cho
authors.forename: Jeong Woo
authors.initials: JW
authors.lastname: Lee
mesh_terms: D000208:Acute Disease; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology*; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000382:microbiology; D024881:Drug Resistance, Bacterial; D024841:Fluoroquinolones / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011472:Prostatitis / Q000188:drug therapy* / Q000382:microbiology*; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones