Naber Kurt G, Sörgel Fritz
Urologic Clinic, Hospital St Elisabeth, Straubing, Germany.
Andrologia. 2003 Oct;35(5):331-5.
The theoretical background of drug penetration into the prostate is outlined, emphasizing the phenomenon of ion-trapping and the role of nonionic diffusion of weak acids, bases and amphoteric drugs across biological membranes with a pH gradient. Determination of drug concentrations in human prostatic secretion are problematic because of possible urinary contamination. Studies have been carried out mainly in healthy volunteers. The results have to be interpreted with caution, if not care was taken to rule out or at least identify urinary contamination. Analysing the concentrations of various fluoroquinolones in prostatic and seminal fluid as well as in prostatic tissue, it becomes obvious that the fluoroquinolones differ not only in plasma concentrations but also in their penetration ability to these sites. In spite of intensive investigations, our knowledge is still limited concerning the mechanisms that govern the transport of antibiotic drugs into and their activity in the various prostatic compartments and how the findings can be applied clinically. Nevertheless, overall the concentrations at the site of infection of most of the fluoroquinolones should be sufficient for the treatment of chronic bacterial prostatitis and vesiculitis caused by susceptible pathogens.
概述了药物渗透到前列腺的理论背景，重点强调了离子捕获现象以及弱酸、弱碱和两性药物在存在pH梯度的情况下通过生物膜的非离子扩散作用。由于可能受到尿液污染，测定人前列腺分泌物中的药物浓度存在问题。研究主要在健康志愿者中进行。如果不注意排除或至少识别尿液污染，对结果的解释必须谨慎。分析前列腺液、精液以及前列腺组织中各种氟喹诺酮类药物的浓度后可以明显看出，氟喹诺酮类药物不仅在血浆浓度上存在差异，而且在它们渗透到这些部位的能力上也有所不同。尽管进行了深入研究，但我们对于抗生素药物进入前列腺各个区域的转运机制及其在其中的活性，以及这些研究结果如何应用于临床的了解仍然有限。然而，总体而言，大多数氟喹诺酮类药物在感染部位的浓度应该足以治疗由易感病原体引起的慢性细菌性前列腺炎和精囊炎。
