On the expediency of antibacterial therapy of chronic prostatitis of the IIIA category (choice of antibiotic and the ways of its introduction)


  • М. І. Ухаль Одесский национальный медицинский университет




chronic prostatitis, antibiotic therapy


Objective: to increase the effectiveness of treatment of patients with chronic prostatitis (CP) category IIIA using in the complex treatment of local antibiotics of the third generation, creating the most optimal conditions for their entry and accumulation in the tissues of the prostate (RV).
Materials and methods. The studies were performed in 28 patients with CP at the age of 25-48 years, with disease duration from 3 to 5 years. To improve the effectiveness of the treatment of these patients used an integrated approach taking into account current knowledge about the pathogenesis of abacterial inflammation in the pancreas. For antibacterial therapy courses successively used solutions of antibacterial drugs third generation of Hemet levofloxacin (500 mg) and amikacin sulfate (0.5 g). To relieve irritative urethral symptoms and the urine uretroprostatic refluxive used silodosin (8 mg once a day for 30 days). To improve blood flow and microcirculation the patients were given tadalafil. (5 mg once a day for 14 days).
Results. Proposed comprehensive drug treatment (antibacterial and pathogenetic) has resulted in the majority of patients uretroprostatic eliminate reflux of urine, normalization of clinical symptoms and functional parameters of urodynamics of the lower urinary tract, relieve pain and improve the quality of life in patients with CPS category IIIA.
Conclusion. Chronic inflammation in pancreas in patients of category IIIA is accompanied by a significant violation of clinical symptoms of urination, changes in blood flow in the pancreas, the development of chronic pelvic pain and urodynamics of the lower urinary tract. In the majority of patients with CP category IIIA confirmed uretroprostatic reflexive urine. It was confirmed that comprehensive medical treatment with the inclusion of antimicrobial drugs of the third-generation Hemet to levofloxacin and amikacin sulfate by creating the most optimal conditions for receipt and accumulation of these drugs in the tissues of the pancreas in combination with pathogenesis therapy is effective in the majority of patients.


Pushkar' D.Ju. Hronicheskij abakterial'nyj prostatit: sovremennoe ponimanie problemy / Ju.D. Pushkar', A.S. Segal // Vrachebnoe soslovie. – 2004. – № 5–6. – S. 9–11.

Wagenlehner F. Prostatitis and Male Pelvic Pain Syndrome Diagnosis and Treatment/ F. Wagenlehner, M.E. Naber, K.G. Bschleipfer [et ol.] // Dtsch Arztebl Int. – 2009. – V. 106 (11). – P. 175–183.

Nickel J.C., Repetitive prostatic massage therapy for chronic refractory prostatitis: the Philippine experience / J.C. Nickel, J. Downey, A.E. Feliciano [et ol.] //Tech Urol. – 1999. – V. 5 (3). – P. 51–146.

Nickel J.C. Predictors of patient response to antibiotic therapy for the chronic rrostatitis/chronic pelvic pain syndrome: a prospective multicenter clinical trial / J.C. Nickel // J.Urol. – 2001. – V. 165. – P. 1539–1544.

Garcia-Castillo M. Differences in biofilm development and antibiotic susceptibility among clinical Ureaplasma urealyticum and Ureaplasma parvum isolates. / M. Garcia-Castillo, M.I. Morosini, M. Galvez [et ol.] //J Antimicrob Chemother. – 2008. – V. 62 (5). – P. 1027–1030.

Cai T. Epidemiological features and resistance pattern in uropathogens isolated from chronic bacterial prostatitis/ T. Cai, S. Mazzoli, F. Meacci // J Microbiol. – 2011. – V. 49 (3). – P. 448–454.

Molochkov V.A. Hronicheskij uretrogennyj prostatit/ Molochkov V.A., Il'in I.I. – M.: Medicina, 1998. – 304 s.

Uhal' O.M. Sposib neinvazivnoi' diagnostiki uretroprostatichnogo refljuksu sechi u hvorih na hronichnij prostatit/O.M. Uhal' //Patent. – 2009. – № 44052. Opubl. – 10.09.2009. – bjul. № 17. – S. 24.

Uhal' O.M. Osoblivosti morfogenezu eksperimental'nogo refljukszumov-lenogo hronichnogo prostatitu / O.M. Uhal', M.I. Uhal', F.I.Kostjev // Zdorov'e muzhchiny. – 2010. – № 4. – S. 137–140.

Bjerklund J. The role of antibiotics in the treatment of chronic prostatitis: a consensus statement/ J. Bjerklund // Eur. Urol. – 1998. – V. 34. – P. 457–466.

Anothaisintawee T. Management of chronic prostatitis/chronic pelvic pain syndrome: a systematic review and network meta-analysis/ T. Anothaisintawee, J. Attia, J.C. Nickel // JAMA. – 2011. – V. 305 (1). – P. 78–86.



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