ro13-9904 and Prostatitis

This study aims to scrutinize the hospitalized patients with the diagnosis of acute prostatitis after transrectal ultrasound-guided biopsy of the prostate (TRUSBP) focusing their history of previous antibiotic use, clinical pictures, microbiologic features, and resistance patterns of the isolates.. A retrospective evaluation of the records between 2005 and 2010 revealed 13 patients. All patients received ciprofloxacin 500 mg twice a day starting from the day before TRUSBP for 5 days.. Positive 13 urine and 7 blood samples (Escherichia coli in 12 patients, Enterococcus species in one) were evaluated for resistance patterns. All were resistant to fluoroquinolones. Extended spectrum beta-lactamase producing E. coli isolated in 4 patients were treated with carbapenems. Empirical ceftriaxone was shifted to carbapenem (4 patients), vancomycin (1 patient). Empirical carbapenem was maintained in 5 patients. Seven patients with elevated PSA received fluoroquinolones for 4 weeks before TRUSBP on the assumption that they had subclinical infectious prostatitis. Previous exposure to fluoroquinolones did not lead to important differences in respect to the studied parameters.. The prompt initiation of effective treatment is essential to decrease morbidity and mortality. Empirical treatment would be a second or third generation cephalosporins, or carbapenems according to clinical severity of patients.

Topics: Aged; Anti-Bacterial Agents; Anti-Infective Agents; Antibiotic Prophylaxis; Biopsy; Carbapenems; Ceftriaxone; Ciprofloxacin; Drug Resistance, Multiple, Bacterial; Enterococcus; Escherichia coli; Escherichia coli Infections; Fluoroquinolones; Hospitalization; Humans; Length of Stay; Male; Middle Aged; Prostate; Prostate-Specific Antigen; Prostatitis; Retrospective Studies; Vancomycin

To evaluate the role of transrectal ultrasonography (TRUS) in the diagnosis of acute bacterial prostatitis (ABP) and to analyse the possible relationship between sonographic findings and clinical presentation and evolution, a prospective study using TRUS in patients with ABP was conducted. 45 patients (aged 58.2 +/- 14.6 y; mean +/- SD) with a clinical diagnosis of ABP admitted to a university hospital were studied prospectively. Clinical, analytical and microbiological data were recorded. TRUS was performed on admission and after 1 month of antibiotic therapy. Findings were correlated with clinical and evolutive data. The mean prostatic volume on admission was 40.5 +/- 17.9 ml. 21 patients (46.6%) had sonographically demonstrable lesions in peripheral prostatic lobules. One month later, when treatment had ended, lesions had disappeared or improved in 61.1% of patients, and the mean prostatic volume was 24.3 +/- 10.5 ml (p < 0.0005). Clinical, analytical and microbiological data and evolution of ABP were not significantly different in patients with or without sonographically demonstrable lesions. TRUS does not need to be performed in every patient with suspicion of ABP; the only indication for TRUS in ABP is the exclusion of prostatic abscess.

Topics: Acute Disease; Administration, Oral; Adult; Aged; Bacterial Infections; Ceftriaxone; Ciprofloxacin; Drug Administration Schedule; Drug Therapy, Combination; Endosonography; Follow-Up Studies; Humans; Infusions, Intravenous; Male; Middle Aged; Probability; Prostatitis; Sensitivity and Specificity; Severity of Illness Index; Treatment Outcome; Urinalysis

Topics: Ceftriaxone; Chronic Disease; Humans; Injections, Intramuscular; Male; Prostate; Prostatitis; Semen