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Burke A. Cunha - One of the best experts on this subject based on the ideXlab platform.
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raoultella planticola Chronic Bacterial Prostatitis with prostatic calcifications successful treatment with prolonged fosfomycin therapy
International Journal of Antimicrobial Agents, 2016Co-Authors: Burke A. Cunha, John GianAbstract:ttp://dx.doi.org/10.1016/j.ijantimicag.2016.02.011 treating CBP due to resistant extended spectrum -lactamase (ESBL) positive E. coli in a patient with prostatic calcifications [4,5]. The current recommended duration of treatment for CBP is 4–6 weeks but in difficult cases, particularly those with prostatic calcifications, prostatic radioactive seeds, prostate cancer, etc., longer courses of therapy are often necessary. Following 3 months of fosfomycin treatment, the patient has remained symptomfree/culture negative.
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persistent extended spectrum β lactamase positive escherichia coli Chronic Prostatitis successfully treated with a combination of fosfomycin and doxycycline
International Journal of Antimicrobial Agents, 2015Co-Authors: Arthur Gran, Burke A. Cunha, Muhammad RazaAbstract:Abstract For Chronic Bacterial Prostatitis, there are few oral antibiotics available that are active against common uropathogens and are able to penetrate the non-inflamed prostate at therapeutic concentrations. Oral options to treat Chronic Prostatitis due to Gram-negative bacillary multidrug-resistant organisms are even more limited. We report a case of persistent extended-spectrum β-lactamase (ESBL)-positive Escherichia coli Chronic Prostatitis refractory to antibiotic therapy. Prolonged courses of fosfomycin failed to eradicate the infection. Re-treatment with high-dose fosfomycin again failed to clear the infection. After repeated courses of fosfomycin, the ESBL-positive E. coli remained susceptible to fosfomycin. Transrectal ultrasound revealed prostatic calcifications that were thought to be the reason for antibiotic failure. Following transurethral resection of the prostate (TURP) to remove the prostatic calcifications, the prostatic calcifications remained and the infection persisted. Although the patient's ESBL-positive E. coli was resistant to doxycycline, he was treated with a combination of fosfomycin plus doxycycline. Treatment with fosfomycin and doxycycline rapidly cured his Chronic Prostatitis.
Muhammad Raza - One of the best experts on this subject based on the ideXlab platform.
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persistent extended spectrum β lactamase positive escherichia coli Chronic Prostatitis successfully treated with a combination of fosfomycin and doxycycline
International Journal of Antimicrobial Agents, 2015Co-Authors: Arthur Gran, Burke A. Cunha, Muhammad RazaAbstract:Abstract For Chronic Bacterial Prostatitis, there are few oral antibiotics available that are active against common uropathogens and are able to penetrate the non-inflamed prostate at therapeutic concentrations. Oral options to treat Chronic Prostatitis due to Gram-negative bacillary multidrug-resistant organisms are even more limited. We report a case of persistent extended-spectrum β-lactamase (ESBL)-positive Escherichia coli Chronic Prostatitis refractory to antibiotic therapy. Prolonged courses of fosfomycin failed to eradicate the infection. Re-treatment with high-dose fosfomycin again failed to clear the infection. After repeated courses of fosfomycin, the ESBL-positive E. coli remained susceptible to fosfomycin. Transrectal ultrasound revealed prostatic calcifications that were thought to be the reason for antibiotic failure. Following transurethral resection of the prostate (TURP) to remove the prostatic calcifications, the prostatic calcifications remained and the infection persisted. Although the patient's ESBL-positive E. coli was resistant to doxycycline, he was treated with a combination of fosfomycin plus doxycycline. Treatment with fosfomycin and doxycycline rapidly cured his Chronic Prostatitis.
Yonghyun Cho - One of the best experts on this subject based on the ideXlab platform.
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clinical courses following acute Bacterial Prostatitis
Prostate international, 2013Co-Authors: Byung Il Yoon, Dongseok Han, Seungju Lee, Hyunwoo Kim, Chang Hee Han, Dong Wan Sohn, Yonghyun ChoAbstract:Purpose There are few studies about clinical courses following acute Bacterial Prostatitis (ABP). We evaluated the progression rates of Chronic Bacterial Prostatitis (CBP) and inflammatory Chronic pelvic pain syndrome (CPPS) after ABP treatment. Also evaluated the characteristics of the patients who developed CBP and inflammatory CPPS after ABP treatment. Methods Total 437 patients compatible with a confirmed diagnosis of ABP from 5 urological centers between 2001 and 2010 were enrolled to study. We defined Chronic infection (CI) as a progression to CBP and inflammatory CPPS after treatment of ABP in admission periods when followed up at 3 months or more. Results were analyzed between two groups: recovered without CI (group A, n=385) and developed to CI (group B, n=52). Results Of the 437 ABP patients, 1.3% (6/437) progressed to CBP and 10.5% (46/437) progressed to inflammatory CPPS. The progression rate of CI was 11.8% (52/437). The patients who developed to CI were higher in alcohol consumption rate, diabetes, voiding symptoms, prior manipulation rate, enlarged prostate volume, catheterization history rate and short duration of antibiotic treatment ( P Conclusions The identification and characterization of these factors may accelerate the development of preventive, diagnostic and therapeutic strategies for the treatment of CI from ABP.
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acute Bacterial Prostatitis how to prevent and manage Chronic infection
Journal of Infection and Chemotherapy, 2012Co-Authors: Byung Il Yoon, S W Kim, Dongseok Han, Seungju Lee, Hyunwoo Kim, Chang Hee Han, Yonghyun ChoAbstract: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.
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do escherichia coli extract and cranberry exert preventive effects on Chronic Bacterial Prostatitis pilot study using an animal model
Journal of Infection and Chemotherapy, 2011Co-Authors: Sang Hoon Kim, Seungju Lee, Hyunwoo Kim, Chang Hee Han, Hyun Rim Lee, Dong Wan Sohn, Choong Bum Lee, Yonghyun ChoAbstract:Traditional first-line treatment of Chronic Bacterial Prostatitis (CBP) is administration of empirical antibiotics. However, the efficacy rate is low and long-term antibiotic therapy can result in adverse events and Bacterial resistance. For these reasons, a new treatment or preventive modality that can replace traditional antibiotic therapy is required. There are several reports that E. coli extract has a preventive effect on recurrent urinary tract infection (UTI). Cranberries are also known to have beneficial effects in preventing UTI. To evaluate the preventive effect of E. coli extract and cranberries on CBP, 48 rats were randomly divided into 4 groups; control, ciprofloxacin, E. coli extract, and cranberry groups. All drug treatments were conducted for 3 weeks, and then we developed a CBP rat model. After 4 weeks, the results of microbiological culture of prostate and urine samples as well as histological findings for the prostate were analyzed for each group. The infection rate in the ciprofloxacin group was significantly lower than that in the control group. The microbiological cultures of the prostate and urine samples demonstrated reduced Bacterial growth in all experimental groups compared with the control group. Histopathologic examination showed significantly decreased prostatic inflammation in all groups compared with the control group. These results suggest that E. coli extract has a potential preventive effect on the development of CBP, and cranberry also exhibits promising activity in this context.
Truls Bjerklund E Johansen - One of the best experts on this subject based on the ideXlab platform.
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fosfomycin trometamol and n acetyl l cysteine as combined oral therapy of difficult to treat Chronic Bacterial Prostatitis results of a pilot study
International Journal of Antimicrobial Agents, 2020Co-Authors: Irene Tamanini, Paolo Verze, Alessandro Palmieri, Vincenzo Mirone, Gianni Malossini, Daniele Mattevi, Andrea Novelli, Carlo Tascini, Truls Bjerklund E JohansenAbstract:ABSTRACT This paper presents the results of a pilot study of difficult-to-treat patients (exhibiting several previous treatment failures or detection of ESBL strains) with Chronic Bacterial Prostatitis (CBP) who underwent treatment with fosfomycin trometamol (FT) associated with N-acetyl-L-cysteine (NAC). Twenty-eight patients with clinically and microbiologically confirmed CBP, attending a single Urological Institution between January 2018 and March 2019, were treated with oral administration of 3 g FT once a day for two days and then a dose of 3 g every 48 h for two weeks, in combination with oral administration of NAC 600 mg once a day for two weeks. Clinical and microbiological analyses were carried out at the time of admission (T0) and during follow-up at 1 month (T1) and 6 months (T2) after the treatment end. Symptoms were assessed by the NIH Chronic Prostatitis Symptom Index (CPSI) and International Prostatic Symptom Score (IPSS), and quality of life was assessed by Quality of Well-Being (QoL) questionnaires. Isolated strains were: Escherichia coli (23 patients), Enterococcus spp. (3 patients), Klebsiella oxytoca (2 patients). ESBL strain was found in 19 patients (67.8%). Microbiological eradication was documented in 21 (75%) patients at the second follow-up visit while clinical cure was reached in 20 (71.4%) patients. Significant changes in terms of questionnaires were recorded between baseline and follow-up visits. Fifteen out of 19 patients (78.9%) with ESBL strains were cured. No significant side effects were reported. Fosfomycin trometamol in combination with N-acetyl-L-cysteine is a promising alternative therapy in difficult-to-treat CBP patients.
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fosfomycin trometamol and n acetyl l cysteine as combined oral therapy of difficult to treat Chronic Bacterial Prostatitis results of a pilot study
International Journal of Antimicrobial Agents, 2020Co-Authors: Tony T Cai, Paolo Verze, Alessandro Palmieri, Vincenzo Mirone, Gianni Malossini, Irene Tamanini, Daniele Mattevi, Andrea Novelli, Carlo Tascini, Truls Bjerklund E JohansenAbstract:This paper presents the results of a pilot study of difficult-to-treat patients (exhibiting several previous treatment failures or detection of extended-spectrum beta-lactamase [ESBL] strains) with Chronic Bacterial Prostatitis (CBP) who underwent treatment with fosfomycin trometamol (FT) and N-acetyl-L-cysteine (NAC). Twenty-eight patients with clinically- and microbiologically-confirmed CBP who attended a single urological institution between January 2018 and March 2019 were treated with oral administration of 3 g FT once a day for 2 days, followed by a dose of 3 g every 48 h for 2 weeks, in combination with oral administration of NAC 600 mg once a day for 2 weeks. Clinical and microbiological analyses were carried out at the time of admission (T0) and during follow-up at 1 month (T1) and 6 months (T2) after the end of treatment. Symptoms were assessed by the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) and International Prostatic Symptom Score (IPSS), and quality of life was assessed by Quality of Well-Being (QoL) questionnaires. Isolated strains were Escherichia coli (23 patients), Enterococcus spp. (3 patients), and Klebsiella oxytoca (2 patients). ESBL strain was found in 19 (67.8%) patients. Microbiological eradication was documented in 21 (75%) patients at the second follow-up visit and clinical cure was achieved in 20 (71.4%) patients. Significant changes on questionnaires were recorded between baseline and follow-up visits. Fifteen of 19 patients (78.9%) with ESBL strains were cured. No significant side effects were reported. FT in combination with NAC is a promising alternative therapy in difficult-to-treat CBP patients.
Anthony J Schaeffer - One of the best experts on this subject based on the ideXlab platform.
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Prostatitis Chronic pelvic pain syndrome
Annual Review of Medicine, 2006Co-Authors: Geoffrey M Habermacher, Judd T Chason, Anthony J SchaefferAbstract:We review the diagnosis, categorization, and treatment of Prostatitis/Chronic pelvic pain syndrome based on the National Institutes of Health (NIH) classification. Prostatitis is an extremely common syndrome that afflicts 2%–10% of men. Formerly a purely clinical diagnosis, Prostatitis is now classified within a complex series of syndromes (NIH category I–IV Prostatitis) that vary widely in clinical presentation and response to treatment. Acute Bacterial Prostatitis (category I) and Chronic Bacterial Prostatitis (category II) are characterized by uropathogenic infections of the prostate gland that respond well to antimicrobial treatment. In contrast, Chronic Prostatitis/Chronic pelvic pain syndrome (category III), which accounts for 90%–95% of Prostatitis cases, is of unknown etiology and is marked by a mixture of pain, urinary, and ejaculatory symptoms with no uniformly effective therapy. Asymptomatic inflammatory Prostatitis (category IV) is an incidental finding of unknown clinical significance. This r...
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treatment of Chronic Bacterial Prostatitis with levofloxacin and ciprofloxacin lowers serum prostate specific antigen
The Journal of Urology, 2005Co-Authors: Anthony J Schaeffer, Alan M Tennenberg, James B KahnAbstract:Purpose: We compared baseline and post-therapy prostate specific antigen (PSA) in patients with Chronic Bacterial Prostatitis who were treated with levofloxacin or ciprofloxacin. Materials and Methods: Subset analysis was done using a randomized, multicenter, doubleblind, active control trial of 500 mg levofloxacin daily for 28 days vs 500 mg ciprofloxacin twice daily in 28 days in men with Chronic Bacterial Prostatitis. Results: Of the 377 men in the intent to treat population, including 197 treated with levofloxacin and 180 treated with ciprofloxacin, 35 on levofloxacin and 37 on ciprofloxacin with baseline PSA greater than 4 ng/ml were included in this analysis. Excluded from analysis were 2 levofloxacin treated patients with extremely high PSA at baseline (62 and 103 ng/ml, respectively). Mean baseline PSA SD in the patients analyzed was 8.33 4.46 ng/ml, which decreased to 5.36 3.82 ng/ml after therapy. There was no significant difference in the mean change in PSA between the levofloxacin and ciprofloxacin groups. Approximately 42% of patients with increased baseline PSA had a post-therapy PSA of 4 ng/ml or less. Of patients who were microbiologically evaluable and had normalized PSA after therapy levofloxacin eradicated the pathogen in 90.9% (10 of 11). However, of patients in whom post-therapy PSA remained increased the microbiological eradication rate was 69.2% (9 of 13). Similarly 93.3% of the ciprofloxacin group (14 of 15 patients) with normalized post-therapy PSA experienced microbiological eradication compared with 61.5% (8 of 13) with continued increased PSA after therapy. Conclusions: Approximately 20% of patients diagnosed with Chronic Bacterial Prostatitis had increased PSA. A significant decrease in PSA was observed in these patients after treatment with levofloxacin or ciprofloxacin. An association was observed between Bacterial persistence and the likelihood that PSA would return to normal.