Two case reports of bacterial prostatitis with a proposed treatment for aviators

Bacterial prostatitis is the inflammation of the prostate gland secondary to a bacterial infection, characteristically having a chronic course with sporadic acute exacerbations. While considered to be the most common cause of recurrent bacterial urinary tract infections in the middle-aged adult male, bacterial prostatitis can be difficult to manage satisfactorily, particularly from the aeromedical perspective. The recurrent infection pattern, common for chronic bacterial prostatitis, has recently been better defined with the localization of the bacterial reservoir as being within the lumen of the prostatic ducts. Capitalizing upon "passive ion trapping" of certain lipid soluble antibiotics in this "protected" site, a two-phased, nonsurgical, pharmacological treatment is proposed for aviators. Two representative cases are reported that demonstrate such management within the setting of an operational USAF flight surgeon's office.