Medicus, Vol. 21 No. 1_UGI, 2012.
Review article
The Importance of PK/PD of Antimicrobial Drugs in Chronic Bacterial Prostatitis Treatment
Igor Francetić
; KBC Zagreb
Abstract
Chronic bacterial prostatitis (CBP) is still an important therapeutic problem due to relatively low treatment success rates. One of the reasons is certainly a poor penetration of most antimicrobial drugs into prostatic tissue and secretions. Special attention given to pharmacokinetic properties of antimicrobial drugs, which could treat these complex infections, is therefore understandable. For a successful treatment of any bacterial infection, including CBP, pathogens and their sensitivity should be identified. The isolation of a pathogen in CPB is still a problem due to an ever present dilemma about the most relevant biological sample for microbiological diagnosis. Therefore, there are some not quite understandable differences in the percentages of CPB pathogens isolated in studies conducted so far. Consequently, the success rates of the empirical CPB therapy are below those desired. Some progress in CBP treatment has been achieved thanks to a better understanding and use of pharmacokinetic properties of antimicrobial drugs. The percentage of successfully treated patients with CBP due to E. coli grew from 40% in those treated with trimethoprim as first-line-treatment to 60% in those treated with fluoroquinolones. It remains to be seen whether 4th generation fluoroquinolones will further improve the CBP treatment due to their enhanced pharmacokinetics and high prostate levels. The treatment of CBP due to C. trachomatis has been also improved thanks to the understanding of the azithromycin pharmacokinetic properties. The fact that anti-inflammatory drugs and alpha-adrenergic blockers are used in a considerable number of CBP patients in addition to antimicrobial drugs indicates the complexity of this clinical entity. The results of clinical studies show that the reasons lying behind the insufficiently successful CBP treatment despite a long-term use of one or more antimicrobial drugs remain to be elucidated.
Keywords
chronic bacterial prostatitis; pharmacokinetic and pharmacodynamic properties; azithromycin
Hrčak ID:
89349
URI
Publication date:
23.1.2012.
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