General Internal Medicine Service, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA.
Clin Infect Dis. 2010 Jun 15;50(12):1641-52. doi: 10.1086/652861.
Prostatitis is characterized by voiding symptoms and genitourinary pain and is sometimes associated with sexual dysfunction. Up to 25% of men receive a diagnosis of prostatitis in their lifetime, but <10% have a proven bacterial infection. The causes and treatment of nonbacterial prostatitis are largely unknown, but bacterial prostatitis is caused by infection with uropathogens, especially gram-negative bacilli, although infection is sometimes due to gram-positive and atypical microorganisms. Acute bacterial prostatitis is easily diagnosed (by abrupt urogential and often systemic symptoms, along with bacteriuria) and treated (by systemic antibiotic therapy). Chronic bacterial prostatitis is characterized by prolonged or recurrent symptoms and relapsing bacteriuria; diagnosis traditionally requires comparing urinary specimens obtained before with specimens obtained after prostatic massage. Treating chronic bacterial prostatitis requires prolonged therapy with an antibiotic that penetrates the prostate (ie, one with high lipid solubility, a low degree of ionization, high dissociation constant, low protein binding, and small molecular size). We review recent pharmacological and clinical data on treating bacterial prostatitis.
前列腺炎的特征是排尿症状和泌尿生殖系统疼痛，有时与性功能障碍有关。多达 25%的男性在其一生中被诊断为前列腺炎，但<10%有明确的细菌感染。非细菌性前列腺炎的病因和治疗方法在很大程度上尚不清楚，但细菌性前列腺炎是由尿路病原体感染引起的，特别是革兰氏阴性杆菌，尽管感染有时是由革兰氏阳性和非典型微生物引起的。急性细菌性前列腺炎很容易诊断（通过突然出现的泌尿生殖系统症状和全身性症状，以及菌尿症）和治疗（通过全身抗生素治疗）。慢性细菌性前列腺炎的特征是长期或反复出现症状和复发菌尿症；传统上，诊断需要比较前列腺按摩前后获得的尿液标本。治疗慢性细菌性前列腺炎需要用一种能穿透前列腺的抗生素进行长期治疗（即脂溶性高、电离度低、离解常数高、蛋白结合率低、分子量小的抗生素）。我们回顾了最近关于治疗细菌性前列腺炎的药理学和临床数据。
