Magri Vittorio, Trinchieri Alberto, Pozzi Giacomo, Restelli Antonella, Garlaschi Maria Cristina, Torresani Erminio, Zirpoli Pasquale, Marras Emanuela, Perletti Gianpaolo
Urology and Sonography Outpatient Clinic, Istituti Clinici di Perfezionamento, Milan, Italy.
Int J Antimicrob Agents. 2007 May;29(5):549-56. doi: 10.1016/j.ijantimicag.2006.09.027. Epub 2007 Mar 2.
A total of 137 patients with a diagnosis of chronic bacterial prostatitis (CBP) were subjected to combination pharmacological therapy with antibacterial agents (ciprofloxacin/azithromycin), alpha-blockers (alfuzosin) and Serenoa repens extracts. Of those, 88 patients (64.2%) showed microbiological eradication at the completion of a 6-week cycle of therapy. Of the remaining 49 patients showing persistence of the causative organism(s) or reinfection at the end of treatment, 36 completed a second cycle of combination therapy for 6 weeks: 27 patients (75%) showed eradication of the causative organism, whereas in nine cases persistence or reinfection was observed. The cumulative eradication rate of the present study - calculated on a total of 137 enrolled patients - is 83.9%. Clinical examination showed a marked improvement of signs and symptoms linked to prostatitis. Remarkably, combination therapy could attenuate CBP symptoms prior to microbiological eradication, thus rapidly decreasing the impact of the disease on the quality of life of patients. Clinical remission was extended throughout a follow-up period of 30 months for 94% of patients, whereas seven patients showed relapse of the disease. In summary, our results indicate that about 20% of patients enrolled in this study, who were refractory to a protocol of 6-week combination therapy, could be 'rescued' by a second cycle of treatment. Clinical follow-up data show that combination therapy could ensure extended relief from CBP symptoms, and a general improvement in quality of life.
共有137例被诊断为慢性细菌性前列腺炎（CBP）的患者接受了抗菌药物（环丙沙星/阿奇霉素）、α受体阻滞剂（阿夫唑嗪）和锯叶棕提取物的联合药物治疗。其中，88例患者（64.2%）在6周治疗周期结束时实现了微生物学根除。在其余49例治疗结束时仍有致病微生物持续存在或再次感染的患者中，36例完成了为期6周的第二个联合治疗周期：27例患者（75%）实现了致病微生物的根除，而在9例患者中观察到了持续存在或再次感染。本研究的累积根除率——基于总共137例入组患者计算——为83.9%。临床检查显示与前列腺炎相关的体征和症状有显著改善。值得注意的是，联合治疗可在微生物学根除之前减轻CBP症状，从而迅速降低该疾病对患者生活质量的影响。94%的患者在30个月的随访期内临床缓解持续存在，而7例患者出现疾病复发。总之，我们的结果表明，本研究中约20%对6周联合治疗方案难治的患者可通过第二个治疗周期“挽救”。临床随访数据显示，联合治疗可确保CBP症状得到长期缓解，并总体改善生活质量。
