Extended culture study as a keypoint to rethinking antibiotic therapy for chronic bacterial prostatitis

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Abstract

Objective. To juxtapose the microbiological efficacy of standard and targeted antibiotic therapy (ABT) based on the comparison of the results of extended bacteriology of biomaterial in patients suffering chronic bacterial prostatitis (CBP) before and after treatment.

Materials & methods. Study design: single-centre observational comparative study. Sixty patients with CBP aged 20 to 45 years were included in the study. All patients underwent an initial examination: questioning, Meares-Stamey 4-glass test, extended bacteriology of biomaterial samples, and determination of antibacterial susceptibility (ABS). After the initial examination, the patients were randomly assigned to two groups (30/30 patients). In group (G) 1, antibacterial drugs were prescribed following the EAU guidelines on Urological Infections (monotherapy), in G2, focusing on the results of ABS (mono or combination therapy). Evaluation of the treatment effectiveness and control bacteriology were carried out three months after therapy.

Results. In G1 vs G2, nine vs ten aerobes and eight vs nine anaerobes were identified in the expressed prostate secretion, respectively. The microbial load of the samples in ≥103 CFU / ml was established in G1 vs G2 for five vs ten aerobes and seven vs eight anaerobes, respectively. The highest ABS of bacteria was determined to moxifloxacin, ofloxacin, and levofloxacin. Cefixime was the most active against anaerobes. After treatment, no significant changes in the bacterial spectrum were observed in both groups. A more reliable decrease in the frequency of microorganism identification and the microbial load of the samples was observed in patients with G2 after the targeted ABT.

Conclusion. Targeted ABT based on extended bacteriology can be considered an effective alternative to standard guideline-approved ABT for the treatment of CBP.

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About the authors

Mikhail I. Kogan

Rostov State Medical University

Email: dept_kogan@mail.ru

MD, Dr.Med.Sci., Full Prof., Honored Scientist of the Russian Federation; Head, Department of Urology and Pediatric Urology

Russian Federation, Rostov-on-Don

Khalid S. Ibishev

Rostov State Medical University

Email: ibishev22@mail.ru

MD, Dr.Med.Sci., Assoc.Prof.; Prof., Department of Urology and Pediatric Urology

Russian Federation, Rostov-on-Don

Yulia L. Naboka

Rostov State Medical University

Email: nagu22@mail.ru

MD, Dr. Med.Sci., Full Prof.; Head, Department of Microbiology and Virology No.1

Russian Federation, Rostov-on-Don

Irina A. Gudima

Rostov State Medical University

Email: naguirina22@gmail.com

MD, Dr. Med.Sci., Assoc.Prof.; Prof., Department of Microbiology and Virology No.1

Russian Federation, Rostov-on-Don

Ruslan S. Ismailov

Rostov State Medical University

Author for correspondence.
Email: dr.ruslan.ismailov@gmail.com
ORCID iD: 0000-0003-1958-9858

MD, Cand.Med.Sci.; Assist.Prof., Department of Urology and Pediatric Urology

Russian Federation, Rostov-on-Don

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