Chronic bacterial prostatitis: efficacy of short-lasting antibiotic therapy with prulifloxacin (Unidrox®) in association with saw palmetto extract, lactobacillus sporogens and arbutin (Lactorepens®)

Abstract

BackgroundBacterial prostatitis (BP) is a common condition accounting responsible for about 5-10% of all prostatitis cases; chronic bacterial prostatitis (CBP) classified as type II, are less common but is a condition that significantly hampers the quality of life, (QoL) because not only is it a physical condition but also a psychological distress. Commonly patients are treated with antibiotics alone, and in particular fluoroquinolones are suggested by the European Urology guidelines. This approach, although recommended, may not be enough. Thus, a multimodal approach to the prolonged antibiotic therapy may be helpful.Methods210 patients affected by chronic bacterial prostatitis were enrolled in the study. All patients were positive to Meares-Stamey test and symptoms duration was > 3 months. The purpose of the study was to evaluate the efficacy of a long lasting therapy with a fluoroquinolone in association with a nutraceutical supplement (prulifloxacin 600 mg for 21 days and an association of Serenoa repens 320 mg, Lactobacillus Sporogens 200 mg, Arbutin 100 mg for 30 days). Patients were randomized in two groups (A and B) receiving respectively antibiotic alone and an association of antibiotic plus supplement.ResultsBiological recurrence at 2 months in Group A was observed in 21 patients (27.6%) and in Group B in 6 patients (7.8%). Uropathogens found at the first follow-up were for the majority Gram – (E. coli and Enterobacter spp.). A statistically significant difference was found at the time of the follow-up between Group A and B in the NIH-CPSI questionnaire score, symptoms evidence and serum PSA.ConclusionsBroad band, short-lasting antibiotic therapy in association with a nutritional supplement (serenoa repens, lactobacillus sporogens and arbutin) show better control and recurrence rate on patients affected by chronic bacterial prostatitits in comparison with antibiotic treatment alone.Trial registrationNCT02130713Date of trial Registration: 30/04/2014

SelectMDx and Multiparametric Magnetic Resonance Imaging of the Prostate for Men Undergoing Primary Prostate Biopsy: A Prospective Assessment in a Multi-Institutional Study

“…Avoiding unnecessary prostate biopsies would allow for a reduction in the risk of side effects inherent to prostate biopsies, as well as associated health costs. This is especially relevant when a trans-rectal (TR) route is chosen, since evidence has suggested significantly higher infectious complications following TR biopsies, compared to a transperineal approach [ 48 , 49 ]. Among these tests, a 3-gene urinary panel using HOXC6, TRD1 and DLX1 were proposed in 2015 by Leyten et al [ 50 ].…”

“…If comparing standard of care for PCa diagnosis with SelectMDx, it could be a potentially correct cost-effective strategy [ 54 , 55 , 56 ]. On the contrary, comparing the performance of mpMRI with biomarkers, it seems that minimizing cost and maximizing effectiveness, would be the optimal strategy [ 48 ]. Future research should address the cost-effectiveness of SelectMDx compared with mpMRI and other biomarkers in order to offer to the clinicians the best diagnostic toll at the lowest price.…”

The Clinical Efficacy of Nitrofurantoin for Treating Uncomplicated Urinary Tract Infection in Adults: A Systematic Review of Randomized Control Trials

“…First, all of the trials included in our review were Urol Int 2021;105:531-540 DOI: 10.1159/000512582 restricted to female participants. Generally, UTIs in men are considered to be complicated because the prostate is often involved [30], although in some rare circumstances they could be considered uncomplicated in young men with a UTI without systemic symptoms, where the patient's medical history and physical examination do not suggest a causative factor [2]. Our search did not find any RCTs on the efficacy of nitrofurantoin for treating uUTI in men.…”

Efficacy and safety of Finasteride (5 alpha-reductase inhibitor) monotherapy in patients with benign prostatic hyperplasia: A critical review of the literature

“…While finasteride inhibits only type 2 5-ARI, dutasteride inhibits both type 1 and 2, but both medications have shown similar efficacy (5). Primary medical management of men with BPH/LUTS include alpha-blockers and 5-ARI as standard therapy and Serenoa repens with more limited efficacy (6)(7)(8). Combination treatment with alpha blockers have been demonstrated to be able to significantly decrease prostate volume (PV), improve International Prostate Symptom Score (IPSS), improve Q max , decrease risk of acute urinary retention (AUR) and operative procedures related with BPH/LUTS better than finasteride alone.…”