Norfloxacin in prostatitis: correlation between HPLC tissue concentrations and clinical results

Prostatic infections are difficult both to diagnose and to treat and have negative influences on the fertility of the patient. Norfloxacin, a new quinolone antibacterial agent particularly active in urinary tract infections, gave excellent results (400 mg every 12 h for 10 days) in the treatment of chronic-relapsing prostatitis in a group of 20 patients. An 85% success rate was recorded at the end of a follow-up period of 30 days without any undesired effects. This clinical study was paralleled by a pharmacokinetic evaluation of the serum, urine and prostatic tissue concentrations attained by the drug, measured by an HPLC assay on biological fluids and tissue extracts from surgical specimens of 15 patients suffering from benign prostatic hypertrophy and given two 400 mg doses of norfloxacin in the 12 h preceding prostatectomy. The average tissue concentrations (1 microgram/gm), as compared with the MIC90 of the drug for the pathogens sustaining prostatic infections, appear quite sufficient to control the bacterial foci responsible for the chronic-relapsing course of prostatitis and easily account for the clinical success rate.