tetracycline and Prostatitis

Prostatitis remains a challenging condition. The clinical features are often nonspecific while the aetiology and pathogenesis can be diverse and includes inflammatory, obstructive, and/or chemical causes and may also be related to calculi. Four categories are recognized: acute bacterial prostatitis, chronic bacterial prostatitis, non-bacterial prostatitis and prostatodynia. The diagnosis of prostatitis was advanced substantially by the introduction of sequential sampling of urine aliquots following prostatic massage. Bacterial prostatitis is largely associated with the Enterobacteriaceae although Pseudomonas spp., enterococci and Staphylococcus aureus may also be isolated. In chronic bacterial prostatitis a variety of streptococci and anaerobic bacteria may be isolated. Treatment is difficult largely owing to the limited range of agents able to achieve therapeutic concentrations within prostatic fluid, which has a pH lower than that of plasma. Trimethroprim, co-trimoxazole and the tetracyclines have been widely used. The quinolones have recently been shown to diffuse readily into the prostate; ofloxacin and temafloxacin have produced the highest concentrations in prostatic fluid. Antibiotic treatment requires prolonged high dosage and careful monitoring to ensure that bacterial eradication has occurred. Other forms of management have included the judicious use of anti-inflammatory agents and analgesics. In some patients zinc sulphate has proved to be of symptomatic benefit.

Topics: Acute Disease; Adult; Anti-Infective Agents, Urinary; Bacterial Infections; Chronic Disease; Colony Count, Microbial; Enterobacteriaceae Infections; Humans; Male; Prostatitis; Pseudomonas Infections; Staphylococcal Infections; Tetracycline; Trimethoprim

Tetracyclines have an unusually broad spectrum of antimicrobial activity. They are generally well tolerated, with relatively few side effects compared with alternative antibiotic choices. Tetracyclines also compare favorably with newer antimicrobials, i.e., oral quinolones, with respect to cost and microbial resistance. Doxycycline's and minocycline's spectrum of antibacterial activity, pharmacokinetic profile, and safety profile make them preferred drugs when tetracyclines are indicated in urologic infections.

Topics: Bacteria; Female; Gonorrhea; Humans; Intestinal Absorption; Lymphogranuloma Venereum; Male; Prostate; Prostatitis; Pyelonephritis; Tetracycline; Tetracycline Resistance; Tissue Distribution; Urethritis; Urinary Tract Infections

Acute bacterial prostatitis caused by common urinary tract pathogens is an infrequent disease, and diagnostic difficulties are rarely encountered. On the other hand, chronic prostatitis is a common disease requiring rather elaborate diagnostic procedures. We applied the localization protocol of the four-specimen technique and combined quantitative determinations of microorganisms and quantitative cytologic analysis plus, in chlamydial infections, serologic investigations. Our studies provide good evidence that Ureaplasma urealyticum and Chlamydia trachomatis must be considered etiologic agents in many cases of chronic bacterial prostatitis. These unconventional microorganisms are assumed to infect the prostate by way of intracanalicular ascension from the urethra.

Topics: Chlamydia Infections; Chlamydia trachomatis; Chronic Disease; Humans; Male; Mycoplasma Infections; Prostatitis; Tetracycline; Ureaplasma; Urethra; Urine

Historically chronic bacterial prostatitis in the male human has been relatively resistant to antimicrobial chemotherapy. The pharmacokinetic theory of drug diffusion into the prostate is reviewed. A brief description of the various canine models utilized to quantitate antimicrobial drug diffusion is presented. Specific data concerning the diffusion of various antimicrobial agents are abstracted followed by a brief discussion of mechanistic explanations for the success or failure of drug therapy.

Topics: Aminoglycosides; Animals; Anti-Bacterial Agents; Anti-Infective Agents, Urinary; Bacterial Infections; Cephalosporins; Chronic Disease; Dogs; Kinetics; Male; Penicillins; Prostatitis; Sulfonamides; Tetracycline; Trimethoprim

Topics: Anti-Bacterial Agents; Carbenicillin; Clindamycin; Diarrhea; Enterocolitis, Pseudomembranous; Erythromycin; Humans; Legionnaires' Disease; Lung Diseases; Male; Methicillin; Penicillin Resistance; Prostatitis; Staphylococcal Infections; Staphylococcus aureus; Streptococcus pneumoniae; Tetracycline; Urethritis; Vancomycin

Topics: Administration, Oral; Arthritis, Reactive; Candida; Chlamydia; Coitus; Culture Media; Epididymitis; Female; Gonorrhea; Humans; Male; Mycoplasma; Neisseria gonorrhoeae; Prostatitis; Recurrence; Tetracycline; Urethral Stricture; Urethritis; Urine

To investigate the relationship between nanobacterial infection and type III prostatitis. The etiology of type III prostatitis remains unclear to date, although the recently discovered nanobacteria (NB) have been implicated in this disease.. A total of 48 patients with chronic pelvic pain syndrome for whom conventional therapy had failed were selected and randomly divided into two groups, one receiving anti-NB treatment and the other receiving a placebo. The NB were isolated and cultured from expressed prostatic secretions and urine samples before and after treatment. The morphologic features were recorded and 16s rRNA gene expression was determined. The curative effect was evaluated by the NB-positive rate and symptomatic changes using the National Institutes of Health Chronic Prostatitis Symptom Index.. After anti-NB treatment, the NB-positive rates had decreased from 62.5% to 16.7% in the expressed prostatic secretions and from 12.5% to 0% in the urine samples after prostatic massage (P <0.001). In the patients receiving a placebo, the positive rates had no obvious change in either the expressed prostatic secretions or the urine samples after prostatic massage (P >0.05). The NB were coccoid or coccobacillary and clustered in a diameter of 100 to 500 nm. The BLAST result revealed that the 16s rRNA gene sequence from the NB in the patients with chronic pelvic pain syndrome was 97%, similar to that of the known NB with identity (97%). After anti-NB treatment, the Chronic Prostatitis Symptom Index scores decreased significantly. In contrast, no change in the Chronic Prostatitis Symptom Index scores was seen after placebo treatment.. The results of our study have shown that nanobacterial infection might be an important etiologic factor of type III prostatitis. Anti-NB treatment could be an effective therapy against refractory type III prostatitis.

Topics: Adult; Anti-Bacterial Agents; Bacteria; Humans; Male; Middle Aged; Nanoparticles; Prostatitis; Tetracycline

Chronic prostatitis is a common disorder sometimes caused by bacterial infection of the prostate. Documentation of such infection requires quantitative culture of carefully collected sequential urine and prostatic fluid specimens (bacterial localization cultures). However, culture of the midstream urine and prostatic fluid alone usually is sufficient to rule out this diagnostic possibility. A practical strategy for the bacteriologic investigation of chronic prostatitis that combines each of these maneuvers--midstream urine and prostatic fluid culture first, then subsequent bacterial localization cultures if pathogenic bacteria are isolated from the initial cultures--is outlined.

Topics: Anti-Infective Agents, Urinary; Bacterial Infections; Bacteriological Techniques; Bacteriuria; Chronic Disease; Humans; Male; Prostate; Prostatitis; Specimen Handling; Tetracycline

Topics: Adult; Anemia, Hemolytic, Autoimmune; Drug Hypersensitivity; Humans; Male; Prostatitis; Tetracycline

The case of an infertile man with oligospermia and symptoms of urethritis-prostatitis, whose spouse had a vaginal discharge, is reported. Microbiological analysis of appropriate specimens revealed a strain of tetracycline-resistant ureaplasma urealyticum in both patients. Using the transmission electron microscope, it was possible to demonstrate spermatozoal heads "infected" with microorganisms strongly resembling ureaplasma urealyticum.

Topics: Adult; Chlamydia Infections; Chlamydia trachomatis; Drug Resistance, Microbial; Female; Humans; Infertility, Male; Male; Mycoplasmatales Infections; Prostatitis; Sperm Head; Spermatozoa; Tetracycline; Ureaplasma; Urethritis; Vaginitis

Chlamydia (C.) trachomatis was isolated in McCoy cell cultures from urethral swabs after prostatic massage, of 43 out of 233 patients (18.5%) with symptoms of "abacterial" prostatitis, but also from 5 out of 65 control persons (7.7%). Numbers of granulocytes in sediments of cytocentrifuged urine voided after prostatic massage were normal (less than or equal to 2, magn. 400 X) in all 65 control persons, but were increased in 26 out of 43 patients with symptoms of "abacterial" prostatitis (greater than or equal to 4, magn. 400 X). Using an (H + L) chain specific anti-IgG FITC conjugate, microimmunofluorescence tests for detection of antibodies against C. trachomatis could be performed with the sera of all 65 control persons and with those of 37 out of the 43 patients. All control persons, even those five with positive C. trachomatis culture, were serologically negative (titer less than 1:8), while in 13 out of 15 C. trachomatis positive patients with a definitive diagnosis of "abacterial" prostatitis, humoral antibodies with titers of greater than or equal to 1:8, predominantly against serotypes I, J, E, and G, were detected. Serological results correlated well with granulocyte counts in urines after prostatic massage. Patients with symptoms of "abacterial" prostatitis with normal granulocyte counts (less than or equal to 2) and negative serology (titer less than 1:8) were considered suffering from "prostatodynia".

Topics: Adolescent; Adult; Aged; Antibodies, Bacterial; Chlamydia trachomatis; Fluorescent Antibody Technique; Granulocytes; Humans; Male; Middle Aged; Prostatitis; Tetracycline; Urethra; Urine

We studied 187 men with symptoms and signs of chronic prostatitis or prostatosis and 108 healthy controls. Ureaplasma urealyticum was isolated from 103 (55.1 per cent) of the patients and from 24 (22.2 per cent) of the controls. When quantitative culture of Ureaplasma urealyticum is considered a typical histogram of prostatitis was evident in 36 patients (19.3 per cent) using the Stamey localization technique. In 20 of the 36 patients the etiology was uncertain for various reasons. Evidence was provided that Ureaplasma urealyticum could be considered as the etiologic agent of the disease in at least 16 (8.6 per cent) of the 187 patients with chronic prostatitis studied.

Topics: Adolescent; Adult; Chronic Disease; Follow-Up Studies; Humans; Male; Middle Aged; Mycoplasmatales Infections; Prostatitis; Semen; Tetracycline; Ureaplasma; Urethritis

Bacterial isolates from expressed prostatic secretions were tested in vitro for susceptibility to five antimicrobial agents used in the treatment of prostatitis. Comparisons of susceptibility and resistance were made between minocycline and each of the other four agents: tetracycline, cephalexin, ampicillin, and trimethoprim-sulfamethoxazole. A high percentage of the isolates from patients with prostatitis which were resistant to tetracycline and trimethoprimsulfamethoxazole were susceptible to minocycline.

Topics: Ampicillin; Anti-Bacterial Agents; Bacteria; Cephalexin; Drug Combinations; Humans; Male; Minocycline; Penicillin Resistance; Prostate; Prostatitis; Sulfamethoxazole; Tetracycline; Trimethoprim

Topics: Arthritis, Reactive; Humans; Male; Prostatitis; Tetracycline

Topics: Anti-Bacterial Agents; Cell Membrane Permeability; Chlamydia; Erythromycin; Genital Diseases, Male; Humans; Male; Mycoplasma; Prostatitis; Seminal Vesicles; Tetracycline; Tinidazole; Trichomonas Infections

312 patients with non-specific prostato-urethritis were investigated with a standardised procedure using the four glass test. In 42.3% of patients mycoplasma was isolated which in almost all cases was Ureaplasma urealyticum. Clinically patients were symptom-free after eradication of mycoplasma in cases where previously urea-plasma counts of more than 10,000 CFU/ml prostatic secretion and of more than 1000 CFU/ml urine had been demonstrated. In cases where there were smaller counts of Ureaplasma urealyticum and where Mycoplasma hominis had been demonstrated tetracycline therapy did not lead to cure in any case.

Topics: Adult; Cell Count; Humans; Male; Middle Aged; Prostatitis; Tetracycline; Ureaplasma; Urethritis

Topics: Adult; Diagnosis, Differential; Drug Combinations; Epididymitis; Gonorrhea; Hernia; Humans; Infant, Newborn; Infrared Rays; Male; Orchitis; Penicillins; Phenylbutazone; Prognosis; Prostatitis; Spermatic Cord Torsion; Sulfamethoxazole; Testicular Neoplasms; Tetracycline; Trimethoprim; Tuberculosis

Our investigationes during the last seven years stress the importance of mycoplasma hominis and ureaplasma on the so called abacterial inflammation of the urogenital tract. Because of diagnostic problems and differential diagnoses only specialized centers should explore these inflammatory conditions. Therapy is possible, however, by dermatologists, urologists, gynecologists, and general practitioners.

Topics: Diagnosis, Differential; Doxycycline; Erythromycin; Female; Humans; Male; Mycoplasma; Mycoplasma Infections; Prostatitis; Specimen Handling; Tetracycline; Ureaplasma; Urethritis; Urinary Tract Infections

The functional state of the testis due to the effect of antibacterial therapy was studied in 50 patients suffering from chronic inflammatory diseases of the urinary-genital system and treated with neomycin, streptomycin, tetracycline, furadonin and furagin. It was shown that the above nitrofurans and neomycin had a negative effect on the testis function lowering the number of the spermatozoa in 1 ml and the whole ejaculate and their mobility. Contrary to it tetracycline therapy had no significant effect on the spermatozoa number, while the use of streptomycin was accompanied by a certain tendency to an increase in their number. The data were to some extent in certain accordance with the results of the experimental studies.

Topics: Adult; Anti-Bacterial Agents; Chronic Disease; Depression, Chemical; Humans; Hydantoins; Male; Middle Aged; Neomycin; Nitrofurans; Nitrofurantoin; Prostatitis; Sperm Motility; Spermatogenesis; Spermatozoa; Streptomycin; Testis; Tetracycline; Time Factors; Urethritis

Topics: Chlamydia; Chlamydia Infections; Complement Fixation Tests; Humans; Male; Prostatitis; Tetracycline

Topics: Adolescent; Adult; Anesthesia, Conduction; Chronic Disease; Follow-Up Studies; Humans; Male; Methods; Middle Aged; Oleandomycin; Procaine; Prostatitis; Tetracycline

Topics: Ampicillin; Gonorrhea; Humans; Male; Neisseria gonorrhoeae; Prostate; Prostatitis; Semen; Tetracycline; Urethra; Urethritis

Topics: Animals; Bacterial Infections; Blood Proteins; Body Fluids; Cell Membrane Permeability; Diffusion; Dogs; Epithelium; Ions; Lipids; Male; Prostate; Prostatitis; Protein Binding; Solubility; Tetracycline

Topics: Adult; Arthritis, Reactive; Culture Media; Erythromycin; Female; Humans; Male; Mycoplasma; Mycoplasma Infections; Prostatitis; Tetracycline; Urethritis; Urinary Tract Infections

Topics: Adult; Aged; Bacteriuria; Cystitis; Drug Resistance, Microbial; Female; Humans; Male; Middle Aged; Prostatitis; Pseudomonas; Pyelonephritis; Tetracycline; Urinary Tract Infections

Topics: Anti-Bacterial Agents; Antibiotics, Antitubercular; Dermatologic Agents; Humans; Male; Prostatitis; Protein Synthesis Inhibitors; Tetracycline; Trichomonas; Trichomonas Infections; Urethritis

Topics: Anti-Bacterial Agents; Chloramphenicol; Humans; Hydrocortisone; Male; Prostate; Prostatitis; Protein Synthesis Inhibitors; Tetracycline; Urinary Bladder Diseases

Topics: Anti-Bacterial Agents; Humans; Male; Prostatectomy; Prostatitis; Protein Synthesis Inhibitors; Tetracycline; Typhoid Fever