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Chronic bacterial prostatitis: theoretical and experimental considerations.

P O Madsen, K M Jensen, P Iversen

    Urological Research
    |January 1, 1983
    PubMed
    Summary
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    Treatment for chronic bacterial prostatitis yields poor results. Research shows local antibody production, but drug penetration into human prostates is complex, suggesting long-term lipid-soluble base treatment.

    Area of Science:

    • Urology
    • Immunology
    • Pharmacology

    Background:

    • Chronic bacterial prostatitis treatment outcomes are often disappointing.
    • Understanding the immunological response and drug penetration is crucial for effective therapy.

    Purpose of the Study:

    • To review the current antimicrobial and immunological research on chronic bacterial prostatitis.
    • To evaluate drug penetration into the prostate and its implications for treatment.

    Main Methods:

    • Analysis of antibody response in acute versus chronic bacterial prostatitis.
    • Review of studies on drug penetration into the prostate, primarily in canine models.
    • Consideration of physiological differences between canine and human prostatic secretions.

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    Main Results:

    • Local antibody production, predominantly immunoglobulin A, is specific to the infecting organism in chronic bacterial prostatitis.
    • Canine studies suggest lipid-soluble bases are ideal for prostate penetration due to ion-trapping in acidic secretions.
    • Human prostatic fluid alkalinity and interstitial inflammation complicate drug penetration, with trimethoprim showing active secretion.

    Conclusions:

    • Current treatment strategies for chronic bacterial prostatitis require re-evaluation based on immunological and pharmacokinetic findings.
    • Long-term administration of lipid-soluble bases with low plasma protein binding is recommended for treating chronic bacterial prostatitis.