Cefoxitin-based antibiotic therapy for extended-spectrum β-lactamase-producing Enterobacteriaceae prostatitis: a...

Area of Science:

• Infectious Diseases
• Urology
• Pharmacology

Background:

• Extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) infections pose a significant therapeutic challenge.
• Prostatitis caused by ESBL-E requires effective treatment strategies due to increasing antibiotic resistance.

Purpose of the Study:

• To evaluate the efficacy of cefoxitin-based antibiotic therapy for patients with ESBL-E prostatitis.
• To assess clinical and microbiological outcomes in patients resistant to trimethoprim/sulfamethoxazole and fluoroquinolones.

Main Methods:

• A prospective study of 23 patients with ESBL-E prostatitis from January 2014 to March 2016.
• Treatment involved cefoxitin by continuous infusion (3-6 weeks) and intravenous fosfomycin (5 days).
• Clinical and microbiological efficacy were assessed at 3 and 6 months post-therapy.

Main Results:

• Clinical cure was achieved in 83% at 3 months and 77% at 6 months.
• Sterile urocultures were observed in 57% at 3 months and 47% at 6 months.
• No cefoxitin resistance emerged, though 30% required surgical intervention.

Conclusions:

• Cefoxitin-based therapy is a viable option for treating challenging ESBL-E prostatitis.
• This regimen demonstrates clinical effectiveness in patients with limited therapeutic choices.
• Further research may explore optimizing treatment duration and managing underlying urinary tract pathologies.