Kontogiannis Dimitrios S, Agoranou Maria Eleni, Dimitriadis Fotios, Skouteris Vassilios M, Falagas Matthew E
Alfa Institute of Biomedical Sciences (AIBS), 9 Neapoleos Street, Marousi, Athens, 151 23, Greece.
Department of Urology, Aristotle University School of Medicine, Thessaloniki, Greece.
Eur J Clin Microbiol Infect Dis. 2025 May 23. doi: 10.1007/s10096-025-05173-x.
Bacterial prostatitis is a common infection affecting the patient's quality of life. It is caused by various bacteria, including multidrug-resistant Enterobacterales. Fosfomycin is active against most implicated pathogens, has good penetration in the prostate, and thus, has been used in patients with bacterial prostatitis.
A systematic review of studies assessing the effectiveness of fosfomycin in adult patients with bacterial prostatitis. The primary outcome was clinical cure and secondary outcomes were microbiological cure, re-occurrence, and adverse events.
Four cohort studies and 1 phase I-II trial were identified, including 117 patients with chronic and acute bacterial prostatitis. In 4 studies with chronic bacterial prostatitis, 72/99 (73%), 77/99 (78%), and 15/99 (15%) of patients had clinical cure, microbiological cure, and adverse events, respectively. In 1 study with acute bacterial prostatitis, 18/18 (100%), 11/12 (92%), and 2/18 (11%) of patients had clinical cure, microbiological cure, and adverse events, respectively. Also, 12 case reports were identified. In 5 cases with chronic bacterial prostatitis, 2/5 had both clinical and microbiological cures, and 1/5 had mild adverse events. In 8 patients with acute bacterial prostatitis, 8/8, 6/8, and 2/8 had clinical cure, microbiological cure, and adverse events, respectively.
Fosfomycin could be valuable in the treatment of patients with bacterial prostatitis when there are no other antibiotic options. Due to the limited available published clinical data, a more rigorous evaluation of its effectiveness and safety in this population is needed.
细菌性前列腺炎是一种常见感染，会影响患者的生活质量。它由多种细菌引起，包括耐多药肠杆菌科细菌。磷霉素对大多数相关病原体具有活性，在前列腺中具有良好的穿透力，因此已用于细菌性前列腺炎患者。
对评估磷霉素在成年细菌性前列腺炎患者中有效性的研究进行系统评价。主要结局为临床治愈，次要结局为微生物学治愈、复发和不良事件。
确定了4项队列研究和1项I-II期试验，包括117例慢性和急性细菌性前列腺炎患者。在4项慢性细菌性前列腺炎研究中，分别有72/99（73%）、77/99（78%）和15/99（15%）的患者实现了临床治愈、微生物学治愈和出现不良事件。在1项急性细菌性前列腺炎研究中，分别有18/18（100%）、11/12（92%）和2/18（11%）的患者实现了临床治愈、微生物学治愈和出现不良事件。此外，还确定了12例病例报告。在5例慢性细菌性前列腺炎病例中，2/5实现了临床和微生物学治愈，1/5出现了轻度不良事件。在8例急性细菌性前列腺炎患者中，分别有8/8、6/8和2/8的患者实现了临床治愈、微生物学治愈和出现不良事件。
当没有其他抗生素选择时，磷霉素在治疗细菌性前列腺炎患者方面可能具有价值。由于公开的临床数据有限，需要对其在该人群中的有效性和安全性进行更严格的评估。
