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Prostatitis is a major urological disease affecting 25%–50% of men over their lifetime. However, prostatitis is often overlooked in nonurologic departments due to its sometimes indeterminate symptoms. In this review, we describe how to recognize and treat acute bacterial prostatitis, which manifests as a clinical problem in other departments as well as urology, to help prevent this disease from being overlooked. There are several possible negative effects of not recognizing acute bacterial prostatitis (ABP). First, initial treatment can fail. In the hyperacute phase, common antibiotics are often effective, but in rare cases, such antibiotics may not be effective. In addition, once ABP progresses to form a prostate abscess, potentially avoidable surgical interventions are often needed. A second issue is the transition to chronic prostatitis. If chronic bacterial prostatitis progresses, treatment requires long‐term antibiotic administration and the response rate is not high. Some patients may have to deal with urinary tract infections for the rest of their lives. Finally, there is the problem of overlooking the underlying disease. ABP is rare in healthy adult men without underlying disease, including sexually transmitted diseases as well as benign prostatic hyperplasia, urinary stones, and malignant tumors, and may not be obvious. When examining patients with fever of unknown origin, it is necessary to exclude not only infectious diseases but also collagen diseases and malignant tumors. If there are any doubts, we recommend a rectal exam and consultation with a urologist. [ABSTRACT FROM AUTHOR]

Introduction: Acute bacterial prostatitis is characterized by acute inflammation of the prostate gland accompanied by the presence of pain and other urinary tract or systemic symptoms. Prostatitis is a relatively common disease of the urinary tract in men, However, this case reports a man diagnosed with acute bacterial prostatitis with an unusual presentation, as well as an unusual pathogen and a unique mechanism of colonization.Case Report: A 52-year-old male with no past medical history presented to our facility for right-sided buttock pain associated with dysuria, diarrhea, and perianal burning. The patient was diagnosed with sepsis secondary to acute bacterial prostatitis, and the pathogen identified in his urine was Aeromonas hydrophila/A. caviae. His disease process was later recognized as a complication of the use of a P-valve condom catheter while freshwater cave diving.Conclusion: This is the first documented case of prostatitis as a result of the use of a P-valve condom catheter while diving. Furthermore, the pathogen identified is of particular interest as there are very few documented cases of urosepsis secondary to Aeromonas hydrophila or A. caviae.

The study included 30 patients who were diagnosed with acute bacterial prostatitis. The average age of the patients was 32 ± 2 years. The study included patients who gave their consent to participate, who did not have concomitant pathology, which was documented, whose age ranged from 18 to 40 years. Patients over 40 years of age with chronic diseases, patients with an established diagnosis of chronic prostatitis were excluded. All patients were divided into two groups of 15 people. The first (group 2) included patients with OBP who were treated with antibacterial drugs in combination with photodynamic therapy and magnetolaser exposure. The second group (group 1) included 15 patients who received antibacterial therapy and magnetolaser exposure without photodynamic therapy. As a result of the study, it was found that the use of combination therapy leads to faster (on the third day) changes in the microflora and relief of symptoms of acute bacterial prostatitis.

Bacterial prostatitis is a highly prevalent infection responsible for significant morbidity among men. The diagnosis and treatment for bacterial prostatitis remains complicated. The difficulty in diagnosis is in part owing to the paucity of high-quality evidence that guides a clinician's interpretation of patients' history, physical examination, and laboratory findings. Treatment is challenging because of the few antimicrobials capable of prostate penetration, growing antimicrobial resistance limiting effective treatment options, and the high risk of recurrence. We aimed to provide a useful resource for clinicians in effectively diagnosing and managing acute bacterial prostatitis (ABP) and chronic bacterial prostatitis (CBP). A PubMed literature search on prostatitis was performed with no restrictions on publication date. The epidemiology, pathophysiology, diagnosis, and treatment for ABP and CBP are explored using a clinical vignette as relevant context. Bacterial prostatitis can be diagnosed through a focused history and microbiological investigations. The Meares-Stamey 4-glass test or modified 2-glass test can help confirm the diagnosis if uncertainty exists. Typical uropathogens are common contributors to bacterial prostatitis but there is growing interest in exploring the role atypical and traditional non-pathogenic organisms may have. Fluoroquinolones remain first-line therapy, followed by trimethoprim-sulfamethoxazole (TMP-SMX) or doxycycline if the pathogen is susceptible. Fosfomycin has emerged as a repurposed and useful agent because of the increasing incidence of multidrug-resistant pathogens. Selection of appropriate antimicrobial regimens can be challenging and is dependent on the host, chronicity of symptoms, uropathogens' susceptibilities, antimicrobials' side effect profile, and the presence of prostatic abscesses or calcifications. ABP can typically be treated similar to other complicated urinary tract infections. However, CBP requires prolonged therapy, with a minimum of 4 weeks and up to 12 weeks of therapy. [ABSTRACT FROM AUTHOR]

Relevance. Acute bacterial prostatitis is one of the urgent problems in urology. According to the data presented in the literature, the number of men who have been diagnosed with this disease ranges from 10 to 40 %. At the same time, the main etiological factor in the development of this pathology is most often assigned to the bacterial microflora. However, most of the works are devoted to the study of the microflora in chronic prostatitis, and the state of the microflora in acute bacterial prostatitis remains insufficient. The aim of the study is to evaluate the state of prostate secretion microflora in a comparative aspect in healthy individuals and in patients with acute bacterial prostatitis. Materials and Methods. The study included a comparative analysis of microbiological cultures in prostate secretion of 30 people. All examined were divided into two groups: the first included 15 people without established urological pathology, the second - 15 people with an established diagnosis of acute bacterial prostatitis. Results and Discussion. As a result of the study, it was found that when sowing prostate secretion in persons without established pathology, the absence of microorganism growth was not observed in 60 % of observations, while in 40 % of cases, microorganisms growth was obtained. In the group of examined without established urological pathology, the growth of microorganisms of the following was noted: Escherichia coli - in 58 % of observations; Staphylococcus epidermidis - in 10 % of observations; Staphylococcus warnerii - in 6 % cases and Enterobacter spp. - in 26 %. At the same time, the number of detected microorganisms did not exceed 104 CFU/ml. At the same time, the presence of microbial associations was not recorded. In patients with acute bacterial prostatitis, the sterile prostate secret was 13,3 %, and in 86,7 % of people, microflora growth was obtained. Most often, in the group examined with acute bacterial prostatitis, Escherichia coli was obtained - in 45 % of the observations; Klebsiella spp. - in 23 % cases and Proteus spp. - in 19 %. Less often Staphylococcus epidermidis - in 8 % of observations; Enterobacter spp. - 3,2 %. Serratia spp. - 1,1 % and Staphylococcus warnerii - in 0,7 % cases were the least obtained. At the same time, 86 % of observations in this group revealed microbial associations. Conclusion . Comparison of the state of microflora of prostate secretions in healthy individuals and patients with acute bacterial prostatitis revealed that in patients with acute bacterial prostatitis, the absence of inoculated microflora in prostate secretions was 3 times less than in healthy individuals (13.3 % and 40 %, respectively.), and Escherichia coli was the most common microorganism in the group of patients with acute bacterial prostatitis.

Acute and chronic bacterial prostatitis are considered infections which are cumbersome to treat, due to the limited available selection of effective antibiotics and the pharmacologically poor distribution in prostatic tissue. Furthermore, the emergence of novel antimicrobial resistance patterns, such as extended spectrum β‑lactamase (ESBL)‑producing Escherichia coli (E. coli) along with increasing fluoroquinolone resistance poses major clinical concerns in selecting the appropriate therapy to treat and eradicate the infection, particularly considering the outpatient setting. The present study describes the case of a healthy male affected by a first acute bacterial prostatitis episode due to ESBL‑producing E. coli. The patient was successfully treated with oral fosfomycin‑trometamol administration, achieving clinical success with microbiological eradication. The case described in the present study, along with the literature review, encourage and suggest the use of oral fosfomycin for the treat‑ ment of both acute and chronic prostatitis, particularly for outpatients and for those subjects who cannot be administered other antibiotics. [ABSTRACT FROM AUTHOR]

ABSTRACT The aim of the study was to analyze the risk factors for relapse in patients with acute bacterial prostatitis (ABP), focusing on the impact of different antibiotic regimens. We conducted an observational study of all patients diagnosed with ABP (irritative and/or obstructive urinary symptoms, temperature of >37.8°C, and the presence of bacteriuria in urine culture, in the absence of data suggesting pyelonephritis) from January 2017 to December 2018. The main outcome was relapse. We performed a multivariate analysis to identify the risk factors associated with relapse. A propensity score with inverse weighting was applied to attenuate antibiotic selection bias. We included 410 patients. The mean age was 68 years; 28.8% had diabetes mellitus, and 61.1% benign prostatic hyperplasia. The most common isolated bacteria were Escherichia coli (62.4%) and Klebsiella spp. (10%). The overall resistance rate was 39.5% to quinolones. The mortality rate was 1.2%, and the relapse rate was 6.3%. The only independent risk factor for relapse was inadequate antibiotic therapy (odds ratio [OR] 12.3; 95% confidence interval [95% CI], 3.5 to 43.1). When the antibiotic was modified according to the susceptibility pattern, the rates of relapse were 1.8% in those treated with ciprofloxacin, 3.6% with intravenous beta-lactam, 9.3% with co-trimoxazole, and 9.8% with oral (p.o.) beta-lactam (P = 0.03). Treatment with oral beta-lactam (OR, 5.3; 95% CI, 1.2 to 23.3) and co-trimoxazole (OR, 4.9; 95% CI, 1.1 to 23.2) were associated with a risk of relapse. In this large real-life observational study, a significantly higher relapse rate was observed when antibiotic treatment was inadequate. When the antibiotic was tailored, quinolones and intravenous beta-lactams had a lower relapse rate than co-trimoxazole and oral beta-lactams. IMPORTANCE In the manuscript, we report a large series of acute bacterial prostatitis cases and describe data about the etiology, antibiotic resistance rate, and outcome, specially focused on the risk factors for relapse. We found high rates of resistance to the most frequently used antibiotics and a high relapse rate in patients whose treatment was not adjusted according to their microbiological susceptibility. We did not observe differences, though, in mortality or relapse according to appropriate or inappropriate empirical treatment. What is new in this article is the different relapse rates observed depending upon the definitive adequate antibiotic used. Quinolones and intravenous (i.v.) beta-lactam have lower rates of relapse (1.8% and 3.6%, respectively) compared to co-trimoxazole and oral (p.o.) beta-lactam (3.3% and 9.8%, respectively). Clinicians should carefully choose an adequate antibiotic for definitive ABP treatment depending on the results of microbiological isolation, using quinolones as the first option. Whenever quinolones cannot be administered, i.v. beta-lactams seem to be the second-best option.

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Acute bacterial prostatitis can burden patients with an abrupt onset of lower urinary tract symptoms. Proper treatment is necessary to prevent various complications that require hospitalization and surgical intervention. Thus, it is important to know what bacteria may cause this infection and what treatments may lead to a complete resolution. While acute bacterial prostatitis is usually caused by Escherichia coli, Enterobacteriae species, and various other species, Staphylococcus saprophyticus is a relatively unique cause that has seldomly been associated with any prostatic diseases. This case involves a 46-year-old Caucasian male with no previous history of prostate diseases who presented to the clinic with fevers, chills, diarrhea, and resolved urinary symptoms. Upon further clinical workup, the patient was found to have an elevated prostate-specific antigen level, along with a positive urinary culture for Staphylococcus saprophyticus . Following seven days of antibiotic treatment, prostate-specific antigen levels had significantly decreased, and the patient's symptoms had fully resolved. No further symptoms were noted after the completion of the full 28-day course of antibiotics. This paper explores how the patient's social, medical, and surgical history may have led to this type of infection. Focus will be placed on areas of research that need to be extended for future cases of acute bacterial prostatitis caused by Staphylococcus saprophyticus . This case intends to inform future clinical practice by identifying predisposing factors to prevent occurrence and by discussing treatment strategies to achieve infection resolution., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Gabbert et al.)

Acute bacterial prostatitis (ABP) is a common disease in adults but uncommon in children. Here, we report the case of a pediatric patient without any underlying disease who was diagnosed with ABP while trying to determine the cause of fever refractory to antimicrobial therapy. A previously healthy 12-year-old boy presented with a 13-day history of fever and malaise despite initial antimicrobial treatment. Further tests revealed pyuria and enlarged prostate with possible abscesses, which led to the diagnosis of ABP based on a contrast-enhanced computed tomography (CT) scan. Although initial urine cultures were negative, Corynebacterium pyruviciproducens was detected in subsequent cultures. Antimicrobial therapy for 10 weeks led to improvement without relapse. This case demonstrates that ABP can cause fever in children. Moreover, it shows that contrast-enhanced CT imaging can help identify the cause of fever and that administration of antimicrobials before adequate investigations can confound the diagnosis and complicate the treatment., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Kinoshita et al.)

AbstractObjective: We aimed to investigate the incidence and characteristics of acute prostatitis after transrectal prostate biopsy in men whom were given prophylactic ceftibuten combined with gentamicin.Material and Methods: We analyzed the retrospective data from 245 patients who underwent transrectal ultrasound (TRUS) guided prostate biopsy over a 2 year period. Men in which acute prostatitis occured after the procedure were investigated. All patients received 400 mg ceftibuten orally once daily for 5 days, beginning 12 and 2 hours before biopsy; combined with single dose 160 mg gentamicin intramuscularly just before the procedure. All biopsies were performed as outpatient procedures. Results: Of the 245 cases, acute prostatitis developed in 2 (0,8%). Escherichia Coli that was positive for extended spectrum β-lactamase activity was isolated both from blood and urine in 1 case. The bacteria detected in urine and blood cultures were resistant to ciprofloxacin, levofloxacin, gentamicin, cefepime, ceftriaxone and cefuroxime. However, no bacteria was isolated either from blood or urine in the other case. Both patients had acute prostatitis after the first biopsy. Conclusion: Prophylactic ceftibuten combined with single dose gentamicin seems effective in preventing acute bacterial prostatitis after TRUS-guided prostate biopsy. Due to increasing rate of quinolone resistance among the world, alternative prophylaxis regimens including cephalosporins such as ceftibuten should be considered in men undergoing prostate biopsy. Prospective randomized trials with larger series may give more conclusive data.

Background: Prevalence of fluoroquinolone (FQ)-resistant Escherichia coli has been recently increasing worldwide. We analyzed the incidence and characteristics of acute bacterial prostatitis after transrectal ultrasound-guided needle prostate biopsy (TRUSP-Bx) with prophylactic tazobactam/piperacillin (TAZ/PIPC) treatment as an alternative regimen. Methods: A total of 391 patients who underwent TRUSP-Bx were included in the study. All patients received intravenous TAZ/PIPC (4.5 g) 30 minutes before and 6 hours after TRUSP-Bx. Results: Acute bacterial prostatitis developed in six patients (1.5%); the frequency of its occurrence was significantly higher in patients in whom rectal disinfection was not performed (P

The emergence of extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) infections requires re-assessment of therapeutic choices. Here we report the efficacy of cefoxitin-based antibiotic therapy for ESBL-E prostatitis. A prospective study including patients with ESBL-E prostatitis resistant to trimethoprim/sulfamethoxazole and fluoroquinolones from January 2014 to March 2016 was conducted. Cefoxitin was administered by continuous infusion for 3 weeks in the case of acute bacterial prostatitis or 6 weeks in the case of chronic bacterial prostatitis (CBP), with intravenous fosfomycin for the first 5 days. Urological investigations were performed to diagnose underlying urinary tract pathology. Clinical and microbiological efficacy were evaluated 3 months (M3) and 6 months (M6) after the end of therapy. A total of 23 patients were included in the study. The median patient age was 74 years (range 48–88 years). Of the 23 infections, 14 (61%) were CBP and 12 (52%) were healthcare-associated infections. The bacteria involved were Escherichia coli in 11 cases, Klebsiella pneumoniae in 10 cases and Klebsiella oxytoca in 2 cases. Clinical cure was observed in 19/23 patients (83%) at M3 and in 17/22 patients (77%) at M6. Urocultures were sterile in 13/23 patients (57%) at M3 and in 9/19 patients (47%) and M6. Urinary colonisation was observed in 6/19 patients (32%) with clinical cure at M3 and 5/14 patients (36%) with clinical cure at M6. No resistance to cefoxitin was detected. Surgical treatment was required for 7/23 patients (30%). In conclusion, cefoxitin-based antibiotic therapy is suitable for difficult-to-treat ESBL-E infections such as prostatitis. [ABSTRACT FROM AUTHOR]

Objectives: 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 [ABSTRACT FROM AUTHOR]

Acute and chronic bacterial prostatitis are clinically significant entities that can be difficult to diagnose and appropriately treat. Herein, we review when to suspect these clinical conditions, how to diagnose them, and how to effectively treat them based on the extant literature. Our aim was to equip the practicing clinician with the ability to proficiently diagnose and manage acute and chronic bacterial prostatitis, particularly in older patients., (Published by Elsevier Inc.)

Introduction: The aim of this study is to investigate the potential antioxidant and anti-inflammatory effects of thymoquinone (TQ) to improve acute bacterial prostatitis (ABP) induced by Pseudomonas aeruginosa. Material and Methods: A total of 42 male Wistar albino rats were divided into 7 groups as follows: control, ABP (24, 48, and 72 h), and TQ-ABP (24, 48, and 72 h). The prostate tissue samples were assayed for prostate tissue malondialdehyde (MDA) and nitric oxide(NO) levels, and catalase (CAT), superoxide dismutase (SOD), and glutathione peroxidase (GPX) activities. Sections were examined for characteristic histological changes, and a histological scoring system was used. Results: When the ABP groups given TQ (24, 48, and 72 h) were compared to the ABP groups not given TQ, the levels of MDA and NO and the GPX activity were found to be significantly lower in the groups given TQ. Concerning SOD values, the TQ-ABP-72 group was lower in comparison with the ABP-72 and control groups, but statistically higher than the TQ-ABP-48 group (p < 0.05). Concerning CAT activity, only the TQ-ABP-72 and ABP-72 groups had a significant difference with the control group. TQ improved prostate histology significantly only in the TQ-ABP-24 group compared to the ABP-24 group (p < 0.001). Conclusion: Our study demonstrated for the first time that ABP induced by P. aeruginosa had an oxidative effect on prostate tissue and could regress following TQ administrationas shown withthe biochemical and histological findings. Copyright © 2013 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Prostatitis plays a major role in morbidity and mortality related to prostate diseases. The aim of this study was to detect whether thymoquinone (TQ) could ameliorate oxidative damage and the proliferative response induced by Escherichia coli (E. coli) in rats. A total of 42 adult male Wistar rats were used. The rats were randomly divided into seven groups (three treatment groups, three infected groups and one control group). Control group received saline and was killed 24 h after saline administration. Infected rats were killed after 24, 48 and 72 h following direct injection of E. coli into the prostate. Treatment groups were administered with 10 mg/kg dose of TQ intraperitoneally following E. coli injection and after 24 and 48 h following E. coli injection. The rats were killed at 24, 48 and 72 h after the first drug administration. Each group was compared with each other and with the control group. In addition, infected groups were compared with treatment groups. Our findings show that the treatment with TQ has a protective effect against bacterial prostatitis-induced tissue injury. Increase in malondialdehyde levels and histological damage caused by E. coli were improved markedly with TQ treatment. TQ treatment particularly increased the activity of glutathione peroxidase and decreased the activities of catalase and superoxide dismutase. These observations might be attributed, at least in part, to the antioxidant effect of TQ and suggest that it could be a clinically valuable agent in the prevention of acute prostatitis caused by E. coli. [ABSTRACT FROM PUBLISHER]

Objective: To assess the current microbiological profile and sensitivity to antibiotics in patients with acute bacterial prostatitis (ABP). Patients and Methods: In the period 2003-2010, we treated 192 ABP patients, aged from 18 to 85 years (average 56.3 years). We performed a biochemical examination including a microbiological urine examination. After admission, we immediately began the empirical antibacterial treatment. Results: The clinical picture was dominated by pain, prostate enlargement and failure of micturition in 185 (96.4%) patients; 14 (7.3%) patients had acute urinary retention where epicystostomy was necessary. Fever occurred in 177 (92.2%) patients and Escherichia coli was the most frequent etiological agent detected in 103 (53.7%) patients followed by Pseudomonas aeruginosa and Klebsiella species. In 16 (8.3%) patients we found 2 bacteriological strains. Sterile urine was found in 65 (33.8%) patients. Fluoroquinolones, aminoglycosides and cephalosporins were used most frequently. 147 (76.6%) patients were treated according to the microbiological results. Overview of resistance shows an increase in resistance to fluoroquinolones. In 14 (7.3%) patients there was progression to urosepsis. Conclusion: Clinicians should consider local drug-resistance patterns when choosing antibiotics and should adjust the therapy on the basis of bacterial cultures and local sensitivity to antibiotics. Copyright © 2012 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

We conducted a retrospective analysis of acute bacterial prostatitis (ABP) to evaluate the factors of progressing to chronic infection and chronic pelvic pain syndrome IIIa (CPPS IIIa) from ABP. The clinical records of 480 cases compatible with a confirmed diagnosis of ABP from five urological centers between 2001 and 2010 were reviewed. We defined chronic infection (CI) as a progression to chronic bacterial prostatitis (II), epididymo-orchitis, and showing persistent pyuria and bacteriuria after treatment of ABP in admission periods when followed up at 3 months or more. Results were analyzed according to two categories: category I, developed to CI (group A, n = 49) versus recovered without CI or CPPS IIIa (group C, n = 385); and category II, developed to CPPS IIIa (group B, n = 46) versus recovered without CI or CPPS IIIa (group C, n = 385). Of the 480 ABP patients, 10.2% (49/480) progressed to CI and 9.6% (46/480) progressed to CPPS IIIa. The frequency of CI was 11.3% (49/434) and that of CPPS IIIa was 10.7% (46/431). The factors that affected progression to CI were diabetes, prior manipulation, not doing cystostomy, and urethral catheterization ( P < 0.05). The factors that affected progression to CPPS IIIa were the same as CI, but prostate volume was included in the CPPS IIIa group ( P < 0.05). The identification and characterization of these factors may accelerate the development of preventive, diagnostic, and therapeutic strategies for the treatment of CI and CPPS IIIa from ABP. [ABSTRACT FROM AUTHOR]

Abstract: The Korean Association of Urogenital Tract Infection and Inflammation (KAUTII) conducted a multicentre, retrospective analysis of acute bacterial prostatitis (ABP) to document clinical features, management, microbiology and the course of disease. The clinical records of 473 cases compatible with a confirmed diagnosis of ABP from 16 urological centres between 2001 and 2005 were reviewed. Susceptibility of the organisms causing ABP, including Escherichia coli, to ciprofloxacin was shown to be very low, fuelling debate as to the efficacy of ciprofloxacin against uropathogens in Korea. When subcategorised according to history of prior manipulation of the lower urinary tract, there were distinct differences between ABP patients with or without a history of prior manipulation with regard to overall clinical and microbiological features. The difference in the distribution of pathogens between the two groups as well as the difference in susceptibility between E. coli and other pathogens should influence empirical antibiotic treatment. In the group with a history of prior manipulation of the lower urinary tract, ciprofloxacin or cephalosporins alone are an inadequate choice and the combination of cephalosporins and amikacin is recommended for empirical therapy. [Copyright &y& Elsevier]

Objective: To explore the outcome of transurethral resection of the prostate (TURP) in the treatment of refractory recurrent acute bacterial prostatitis. Patients and Methods: From 2004 to 2013, 23 TURP for this indication were performed in 21 patients; two patients underwent it twice. The files of these patients were retrospectively analysed for outcome and side effects. TURP intended to remove as much infected tissue as possible under appropriate antibiotherapy. Results: Twelve patients became free of symptoms during a follow-up of 3-108 months (median 44), two others became disease-free after one and two postoperative attacks, respectively; eight were not cured and had rapid recurrences; three patients had follow-up of a few weeks only. Two failures developed orchiepididymitis shortly after the procedure and one a year later. No incontinence or bladder neck contracture was noted. Conclusion: TURP is an acceptable procedure in the treatment of refractory recurrent bacterial prostatitis. It could cure about two thirds of patients. © 2014 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

The article discusses the prostatitis syndromes, which usually cause pelvic pain and urinary dysfunction in men. The syndromes include acute prostatitis, chronic bacterial prostatitis (CBP), chronic non-bacterial prostatitis (CNBP) and prostatodynia. Chronic prostatitis refers to conditions causing genito-pelvic pain and urinary dysfunction in adult men. CBP causes recurrent bacterial urinary tract infection in men. CNBP refers to a syndrome characterized by genito-pelvic pain in men.

• Current clinical evidence is limited to case reports and case series. • Most available evidence is for chronic bacterial prostatitis caused by Escherichia coli. • A range of dosages and intervals have been used with minimal adverse effects. • Uncertainty remains regarding the most appropriate dosing interval and duration of therapy. • Clinical success was greatest with dosing of 3 g at least every 48 h. • Further studies are required to establish dosing regimen, efficacy and resistance. There has been growing interest in fosfomycin for the treatment of bacterial prostatitis due to evidence suggesting that it achieves adequate prostatic concentrations for antimicrobial effect, has activity against resistant micro-organisms, and has a low-toxicity profile. This review evaluated the current clinical evidence for fosfomycin in acute and chronic bacterial prostatitis to elucidate the clinical implications of fosfomycin in an era of increasing antimicrobial resistance. PubMed, Scopus, EMBASE, Web of Science, Google Scholar and ClinicalTrials.gov were searched for studies published in the English language from January 1984 to November 2019. The inclusion criteria were met if the study reported the use of fosfomycin (more than one dose) to treat bacterial prostatitis. Ten observational studies were identified that met the inclusion criteria. The evidence for the use of fosfomycin in acute bacterial prostatitis is sparse. The majority of the available evidence is for chronic bacterial prostatitis caused by Escherichia coli. Despite the implementation of variable dosing regimens, extended courses of fosfomycin appear to be safe and effective in achieving clinical and microbiological cure. In these studies, the use of fosfomycin was restricted to cases of treatment failure, intolerance to first-line therapy, or multi-resistant organisms. However, given the development of resistant organisms and the undesirable adverse effects of many first-line therapeutic options, fosfomycin has the potential to be considered as an effective first-line alternative for acute and chronic bacterial prostatitis in the future. Further studies, including randomized controlled trials, would be helpful to firmly establish its optimal dosing regimen, efficacy and place in therapy. [ABSTRACT FROM AUTHOR]