Gisbert Laura, Dietl Beatriz, Xercavins Mariona, Mateu Aina, López María, Martínez-Urrea Ana, Boix-Palop Lucía, Calbo Esther
Infectious Diseases Department, Hospital Universitari Mútua Terrassa, 08021 Terrassa, Spain.
Medicine Department, Universitat de Barcelona, 08036 Barcelona, Spain.
Antibiotics (Basel). 2025 Jul 5;14(7):681. doi: 10.3390/antibiotics14070681.
BACKGROUND/OBJECTIVES: Optimal management of acute bacterial prostatitis (ABP) remains uncertain, but the use of antibiotics with good prostatic tissue penetration is critical to prevent recurrence and chronic progression. This study aimed to describe clinical characteristics and outcomes of ABP due to (ABP-), compare effectiveness of sequential high-dose cefuroxime (ABP-CXM) versus ciprofloxacin (ABP-CIP), and identify risk factors for clinical failure.
We conducted a retrospective study including men >18 years diagnosed with ABP- between January 2010 and November 2023 at a 400-bed hospital. Patients received oral cefuroxime (500 mg/8 h) or oral ciprofloxacin (500 mg/12 h). Outcomes over 90 days included clinical cure, recurrence and reinfection.
Clinical cure-resolution of symptoms without recurrences; recurrence-new ABP episode with the same strain; reinfection-ABP involving different microorganism or strain; clinical failure-lack of cure, recurrence, or reinfection.
Among 326 episodes (158 ABP-CXM, 168 ABP-CIP), ABP-CXM patients were younger (median 63.5 vs. 67.5 years, = 0.005) and had fewer comorbidities. Clinical cure was higher in ABP-CIP (96.9% vs. 85.7%, < 0.001). Recurrence occurred only in ABP-CXM (6.96% vs. 0%, < 0.001), while reinfection and mortality were similar. Multivariable analysis showed ciprofloxacin was protective against clinical failure (OR: 0.16, 95% CI: 0.06-0.42, < 0.001), while prior urinary tract infection (UTI) increased failure risk (OR: 2.87, 95% CI: 1.3-6.3).
Ciprofloxacin was more effective than cefuroxime in treating ABP- Patients with recent UTIs may need closer monitoring or alternative therapies.
背景/目的：急性细菌性前列腺炎（ABP）的最佳治疗方案仍不明确，但使用前列腺组织穿透力强的抗生素对于预防复发和慢性进展至关重要。本研究旨在描述因[具体病因未提及]导致的ABP（ABP-）的临床特征和结局，比较序贯高剂量头孢呋辛（ABP-CXM）与环丙沙星（ABP-CIP）的疗效，并确定临床治疗失败的危险因素。
我们进行了一项回顾性研究，纳入了2010年1月至2023年11月期间在一家拥有400张床位的医院确诊为ABP-的18岁以上男性。患者接受口服头孢呋辛（500mg/8小时）或口服环丙沙星（500mg/12小时）。90天内的结局包括临床治愈、复发和再感染。
临床治愈——症状消失且无复发；复发——同一菌株引起的新的ABP发作；再感染——由不同微生物或菌株引起的ABP；临床治疗失败——未治愈、复发或再感染。
在326例发作中（158例ABP-CXM，168例ABP-CIP），ABP-CXM组患者更年轻（中位年龄63.5岁对67.5岁，P = 0.005）且合并症较少。ABP-CIP组的临床治愈率更高（96.9%对87.5%，P < 0.001）。复发仅发生在ABP-CXM组（6.96%对0%，P < 0.001），而再感染和死亡率相似。多变量分析显示环丙沙星可预防临床治疗失败（OR：0.16，95%CI：0.从文中可以看出，ABP的病因处有缺失，翻译时保留了原文的格式。06 - 0.42，P < 0.001），而既往尿路感染（UTI）会增加治疗失败风险（OR：2.87，95%CI：1.3 - 6.3）。
在治疗ABP-方面，环丙沙星比头孢呋辛更有效。近期有UTI的患者可能需要更密切的监测或替代治疗。
