Azithromycin: 4.5- or 6.0- Gram Dose in the Treatment of Patients with Chronic Prostatitis Caused by<i>Chlamydia trachomatis</i>- A Randomized Study

Škerk, Višnja; Krhen, Ivan; Lisić, Miroslav; Begovać, Josip; Čajić, Vjeran; Zekan, Šime; Škerk, Vedrana; Sternak, Sunčanica Ljubin; Topić, Antea; Schönwald, S

doi:10.1179/joc.2004.16.4.408

Cited by 11 publications

(9 citation statements)

References 4 publications

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“…Azithromycin was administered only during the first 3 consecutive days at the beginning of each week of treatment with the fluoroquinolone (''pulse therapy''), as previously described. 18,28,29 In agreement with the algorithm recommended by Wagenlehner and Naber, 30 patients remained on continuous treatment with the alphaadrenoceptor blocker alfuzosin ER (10 mg day 21 ) for a period of 6 months, during which time a supplement containing Serenoa repens extract (640 mg day 21 ), lycopene (5 mg day 21 ) and selenium (50 mg day 21 ) in a single formulation was also administered. 31 Four weeks after the end of antimicrobial treatment, the patients were subjected to a complete diagnostic protocol, including microbiological and clinical evaluations.…”

Section: Diagnostic Proceduresmentioning

confidence: 91%

Fluoroquinolone–macrolide combination therapy for chronic bacterial prostatitis: retrospective analysis of pathogen eradication rates, inflammatory findings and sexual dysfunction

Magri¹,

Montanari²,

Škerk³

et al. 2011

Asian J Androl

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We previously demonstrated the safety and efficacy of fluoroquinolone-macrolide combination therapy in category II chronic bacterial prostatitis (CBP). The aim of this study is to retrospectively compare the microbiological and clinical findings of two treatment schemes for CBP based on the combination of azithromycin (500 mg, thrice-weekly) with a once-daily 500-or 750-mg dose of ciprofloxacin (Cipro-500 or Cipro-750 cohort, respectively). Combined administration of azithromycin (1500 mg week 21 ) with ciprofloxacin at the rate of 750 mg day 21 for 4 weeks rather than at 500 mg day 21 for 6 weeks increased the eradication rates from 62.35% to 77.32% and the total bacteriological success from 71.76% to 85.57%. A significant decrease in pain and voiding signs/symptoms and a significant reduction in inflammatory leukocyte counts and serum prostate-specific antigen (PSA) were sustained throughout an 18-month follow-up period in both groups. Ejaculatory pain, haemospermia and premature ejaculation were significantly attenuated on microbiological eradication in both groups, but the latter subsided more promptly in the Cipro-750 cohort. In total, 59 Cipro-750 patients showed mild-to-severe erectile dysfunction (ED) at baseline, while 22 patients had no ED on microbiological eradication and throughout the follow-up period. In conclusion fluoroquinolone-macrolide therapy resulted in pathogen eradication and CBP symptom attenuation, including pain, voiding disturbances and sexual dysfunction. A once-daily 750-mg dose of ciprofloxacin for 4 weeks showed enhanced eradication rates and lower inflammatory white blood cell counts compared to the 500-mg dose for 6 weeks. Our results are open to further prospective validation.

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Section: Diagnostic Proceduresmentioning

confidence: 91%

Fluoroquinolone–macrolide combination therapy for chronic bacterial prostatitis: retrospective analysis of pathogen eradication rates, inflammatory findings and sexual dysfunction

Magri¹,

Montanari²,

Škerk³

et al. 2011

Asian J Androl

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“…In recent years, 14/15-membered macrolide antibiotics like clarithromycin and azithromycin have been shown to display a significant anti-biofilm intrinsic activity [11]. Due to good penetration/bioavailability in the prostatic tissue fluids and to favourable pharmacodynamic characteristics [12,13], macrolides are currently used in the treatment of Chlamydial prostatitis [14][15][16][17] and have been indicated, together with fluoroquinolones, as preferred drugs for the treatment of prostatitis because of their activity on biofilms [18]. Indeed, combinations of macrolides with fluoroquinolones or betalactam antibiotics have been shown to be safe and effective in patients affected by complicated urinary tract biofilm infections [19,20], and have been suggested to have high therapeutic potential in the treatment of CBP [21].…”

Section: Introductionmentioning

confidence: 99%

Efficacy of repeated cycles of combination therapy for the eradication of infecting organisms in chronic bacterial prostatitis

Magri

Trinchieri

Pozzi

et al. 2007

International Journal of Antimicrobial Agents

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“…This trial was performed in the context of a prospective, comparative and randomized study performed on 89 prostatitis patients, randomized to receive a total dose of 4.5 g of azithromycin administered as a 3-day 'pulse' (500 mg once daily for 3 consecutive days each week) for 3 weeks (46 patients) or a total dose of 6 g of azithromycin administered as a 3-day 'pulse' therapy for 4 weeks (43 patients). Eradication rates under the two regimens were not significantly different (80.43% patients for the 4.5-g group vs. 81.40% for the 6.0-g group) (73). Clinical cure rates also did not significantly differ between total doses of 4.5 or 6.0 g azithromycin (69.57% for the 4.5-g group vs. 72.09% for the 6.0-g group).…”

Section: Clinical Evidence Of Efficacy Of Macrolides In Prostate Infementioning

confidence: 66%

Macrolides for the treatment of chronic bacterial prostatitis: An effective application of their unique pharmacokinetic and pharmacodynamic profile (Review)

et al. 2011

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Abstract. Chronic bacterial prostatitis (CBP) is a persistent infection of the prostate characterized by poor quality of life mainly due to frequent relapse episodes caused by incomplete eradication of causative pathogens. Aggressive antibacterial therapy is required to attenuate the severe symptoms of CBP and to achieve a permanent cure. Although fluoroquinolones are currently recommended as first-choice agents, macrolide antibiotics are emerging as a noteworthy option for the treatment of CBP. Macrolide antibiotics are characteri zed by an impressive array of distinct pharmacokinetic (PK) and pharmacodynamic (PD) properties. These properties include high intracellular accumulation in phagocytes and at sites of infection, including the prostate; broad antibiotic but also biofilm-inhibiting properties; immunomodulating and inflammation-resolving activities. These features offer particular advantages for the treatment of chronic infections of the prostate gland, which are not easily amenable to drug therapy. Macrolides may be exploited to counteract the unsatisfactory rates of clinical symptom improvement and pathogen eradication. The results of a number of clinical trials support this proposal.

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Azithromycin: 4.5- or 6.0- Gram Dose in the Treatment of Patients with Chronic Prostatitis Caused byChlamydia trachomatis- A Randomized Study

Cited by 11 publications

References 4 publications

Fluoroquinolone–macrolide combination therapy for chronic bacterial prostatitis: retrospective analysis of pathogen eradication rates, inflammatory findings and sexual dysfunction

Fluoroquinolone–macrolide combination therapy for chronic bacterial prostatitis: retrospective analysis of pathogen eradication rates, inflammatory findings and sexual dysfunction

Efficacy of repeated cycles of combination therapy for the eradication of infecting organisms in chronic bacterial prostatitis

Macrolides for the treatment of chronic bacterial prostatitis: An effective application of their unique pharmacokinetic and pharmacodynamic profile (Review)

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