Levofloxacin for NIH Category II Chronic Bacterial Prostatitis: A Real-Life Study

Area of Science:

• Urology
• Infectious Diseases
• Pharmacology

Background:

• Antibiotic resistance necessitates evaluating existing treatments for urogenital infections.
• Fluoroquinolones (FQs) like levofloxacin are first-line for chronic bacterial prostatitis (CBP).
• Levofloxacin eradication rates in clinical trials range from 71-86%.

Purpose of the Study:

• To assess levofloxacin's real-world efficacy for CBP.
• To compare levofloxacin monotherapy with combination therapy for CBP.

Main Methods:

• Retrospective review of over 2,500 CBP patient records.
• Patients received 4-week treatment with levofloxacin (500 mg/day), alone or with other antibacterials.
• Utilized the 4-glass test, NIH-CPSI, and IPSS for assessment.

Main Results:

• Levofloxacin monotherapy achieved 79% eradication; combination with azithromycin reached 87.8%.
• The combination therapy showed a statistically significant 11% increase in eradication rates.
• Combination therapy also improved prostate and bladder volumes and symptom scores without adverse effects.

Conclusions:

• Levofloxacin remains effective for CBP in clinical practice.
• Combining levofloxacin with azithromycin enhances eradication rates for CBP.
• This combination is a viable option for CBP, with careful consideration of potential side effects.