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Long‐term Antibiotic Treatment of Chronic Bacterial Prostatitis. Effect on Bacterial Flora
Author(s) -
BERGMAN B.,
WEDREN H.,
Holm S. E.
Publication year - 1989
Publication title -
british journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 0007-1331
DOI - 10.1111/j.1464-410x.1989.tb05944.x
Subject(s) - antibiotics , flora (microbiology) , bacteria , prostatitis , chronic bacterial prostatitis , gram positive bacteria , medicine , colonisation , microbiology and biotechnology , gram negative bacteria , antibiotic therapy , gastroenterology , biology , escherichia coli , colonization , prostate , biochemistry , genetics , cancer , gene
Summary— The bacterial flora in patients referred with chronic bacterial prostatitis were studied. Only 13% had Gram‐negative bacteria in significant numbers but 43% had Gram‐positives using the same criteria. Half of the patients were symptom‐free by the end of a 12‐week course of antibiotics and remained so after 6 months; in one‐third the symptoms were unchanged 6 months after completing treatment. The relief of symptoms correlated with the disappearance of white blood cells in the expressed prostatic secretion (EPS) and with a lowered pH in the EPS. Thus only 1 of the 14 patients without symptoms at 6 months had a significant growth of bacteria at the prostatic level, whereas 7 of 10 patients with unchanged symptoms had a significant bacterial colonisation. Although the initially infecting organism was eliminated in about half of the patients, new Gram‐positive bacteria were isolated after treatment in 13 of 29 patients; 12 of these resolved spontaneously within 6 months. Five patients with Gram‐positive bacteria were colonised with new Gram‐negatives at the end of treatment. Two healed spontaneously but 3 remained colonised with Gram‐negatives at the end of the follow‐up period. These findings make it likely that many patients infected with Gram‐positive bacteria benefit from antibiotic treatment. However, disturbances in the bacterial flora by antibiotic treatment may facilitate invasion by new types of bacteria.