A Community Pharmacist Role in the Treatment of Bacterial Prostatitis

Enterococcci prostatitis


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    The Gram-negative etiology of CBP is also reported in many national and international guidelines, and fluoroquinolones or other agents active against E.

    A very recent survey on the incidence of uropathogens in CBP, performed in Italian patients [ 3 ], showed that Enterococcus faecalis has become the predominant etiologic determinant of this infection. This important finding is not limited to the Italian population or to clinical trials performed in Italy [ 4—6 ].

    The higher prevalence of enterococcal CBP has been reported, for example, in North America [ 78 ]. As early asBundrick described and discussed the preponderance of enterococci in his cohorts of patients with CBP [ 7 ].

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    Such preponderance is also increasingly reported by researchers attending international meetings and symposia worldwide. Enterococcci prostatitis cannot continue to overlook this evidence.

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    This shift in bacterial etiology has profound implications. It is known that the prostatic distribution of second-generation fluoroquinolones, the universally recommended agents in CBP, is suboptimal.

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    The concentrations of these agents in prostatic secretions eg, norfloxacin, 0. This also explains the relatively low eradication rates of E. Enterococcci prostatitis, we have few therapeutic alternatives. Intravenous anti—Gram-positive agents are a hardly conceivable option for long-term treatment. As far as oral agents are concerned, only single-case studies have reported so far the successful outcome of linezolid or moxifloxacin therapy.

    The international challenges of antibacterial treatment emergence of multidrug-resistant enterococcci prostatitis, extended-spectrum beta-lactamase-producing bacteria, bacterial biofilms production and the shift in bacterial etiology and the transformation of therapeutic strategy for classic therapy have attracted worldwide attention. To the best of our knowledge currently, there is not a single comprehensive review, which can completely elaborate these important topics and the corresponding treatment strategy in an effective way. This review summarizes the general treatment choices for bacterial prostatitis also provides the alternative pharmacological therapies for those patients resistant or intolerant to general treatment. Introduction Prostatitis is a common but bothersome urinary tract disease in urological practice that annoys patients and urologists worldwide. The incidence rate of prostatitis just follows those of prostate cancer PCA and benign prostate hyperplasia BPH in all male urinary tract conditions.

    The latter is perhaps the only available fluoroquinolone that may attain prostatic secretions concentrations 3. Regrettably, pharmaceutical companies show little interest in the use of moxifloxacin for new urologic indications, and moxifloxacin will probably remain an off-label drug, to be administered after assessing the cardiovascular, hepatic and nephrologic profile of candidate patients.

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    If this trend continues, second-generation quinolones will soon cease to be the drugs of choice for therapy of CBP. Hence, therapeutic guidelines and treatment recommendations must be refocused accordingly, and intense research is needed to address gaps in our knowledge about the kinetics and accumulation of newer anti—Gram-positive agents in prostatic sites of infection.

    All authors: No reported conflicts. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

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