Long-Term Fosfomycin-Tromethamine Oral Therapy for Difficult-To-Treat Chronic Bacterial Prostatitis

Area of Science:

• Urology
• Infectious Diseases
• Pharmacology

Background:

• Chronic bacterial prostatitis is challenging to treat, often involving infections resistant to standard antibiotics like ciprofloxacin and co-trimoxazole.
• Multidrug-resistant Enterobacteriaceae (MDRE) pose a significant threat in persistent prostatitis cases.
• Previous treatment failures and patient side effects necessitate exploring alternative therapeutic options.

Purpose of the Study:

• To evaluate the efficacy and safety of fosfomycin-tromethamine in patients with difficult-to-treat chronic bacterial prostatitis.
• To assess the microbiological eradication rates in patients receiving fosfomycin-tromethamine, particularly those with MDRE infections.

Main Methods:

• A retrospective study involving 15 patients with chronic bacterial prostatitis.
• Patients received fosfomycin-tromethamine at a dose of 3 g every 48 to 72 hours for 6 weeks.
• Follow-up included clinical assessment and microbiological evaluation for a median of 20 months.

Main Results:

• A clinical response was observed in 7 patients (47%).
• Persistent microbiological eradication was achieved in 8 patients (53%).
• Notably, 4 out of 5 patients with MDRE isolates achieved eradication, with no reported side effects.

Conclusions:

• Fosfomycin-tromethamine demonstrates potential as an effective alternative therapy for chronic bacterial prostatitis.
• The drug is well-tolerated and effective even in cases involving multidrug-resistant pathogens.
• Further prospective studies are warranted to confirm these findings.