We previously demonstrated the safety and efficacy of fluoroquinolone-macrolide combination therapy in category Ⅱ chronic bacterial prostatitis （CBP）. The aim of this study is to retrospectively compare the microbi...We previously demonstrated the safety and efficacy of fluoroquinolone-macrolide combination therapy in category Ⅱ chronic bacterial prostatitis （CBP）. The aim of this study is to retrospectively compare the microbiological and clinical findings of two treatment schemes for CBP based on the combination of azithromycin （500 rag, thrice-weekly） with a once-daily 500- or 750-mg dose of ciprofloxacin （Cipro-500 or Cipro-750 cohort, respectively）. Combined administration of azithromycin （1500 mg week^-1） with ciprofloxacin at the rate of 750 mg day^- 1 for 4 weeks rather than at 500 mg day^- 1 for 6 weeks increased the eradication rates from 62.35% to 77.32% and the total bacteriological success from 71.76% to 85.57%. A significant decrease in pain and voiding signs/symptoms and a significant reduction in inflammatory leukocyte counts and serum prostate-specific antigen （PSA） were sustained throughout an 18-month follow-up period in both groups. Ejaculatory pain, haemospermia and premature ejaculation were significantly attenuated on microbiological eradication in both groups, but the latter subsided more promptly in the Cipro-750 cohort. In total, 59 Cipro-750 patients showed mild-to-severe erectile dysfunction （ED） at baseline, while 22 patients had no ED on microbiological eradication and throughout the follow-up period. In conclusion fluoroquinolone-macrolide therapy resulted in pathogen eradication and CBP symptom attenuation, including pain, voiding disturbances and sexual dysfunction. A once-daily 750-mg dose of ciprofloxacin for 4 weeks showed enhanced eradication rates and lower inflammatory white blood cell counts compared to the 500-mg dose for 6 weeks. Our results are open to further prospective validation.展开更多
The significance and diagnostic value of semen analysis in chronic bacterial prostatitis has been extensively debated and remains controversial. To investigate the diagnostic relevance of semen culture in the bacterio...The significance and diagnostic value of semen analysis in chronic bacterial prostatitis has been extensively debated and remains controversial. To investigate the diagnostic relevance of semen culture in the bacteriological workup of prostatitis patients, we retrospectively analyzed a clinical database of 696 symptomatic patients. All patients were routinely subjected to a four-glass test, followed by semen culture and analysis. This allowed to dissect from the database three different diagnostic scenarios, and to compare the ＇two-glass＇ pre-/post- massage test and the standard ＇four-glass＇ test with a ＇five-glass＇ test （four-glass plus post-VB3 semen culture）. The ＇five-glass＇ test showed 3.6- or 6.5-fold increases in relative sensitivity and lesser reductions （-13.2% or -14.7%） in relative specificity for traditional uropathogens （TUs） compared with the four-glass or two-glass test, respectively. The area under the ROC curve and Jouden＇s index were increased, whereas positive and negative likelihood ratios were lower than comparators, indicating that the ＇five-glass＇ assay may be superior in confirming the negative outcome of both standard tests. The five-, four-, and two-glass tests detected TUs （Enterobacteriaceae, Enterococci, etc.） in 120, 33, and 20 patients and unusual pathogens （Streptococci, other Gram-positive species, Mycoplasmata, and others） in 130, 56, and 45 patients, respectively. When patients were subjected to pharmacological treatment, including a combination of a fluoroquinolone and a macrolide, no differences in eradication rates were observed between groups diagnosed with different tests, irrespective of pathogen category. Eradication was associated with long-term sign/symptom remission; no significant intergroup differences in sign/symptom scores were observed throughout a 24-month off-therapy follow-up period. In conclusion, our data support the usefulness of semen analysis in the diagnostic workup ofprostatitis patients when this test is used to complement the four-glass Meares and Stamey test. Improvement of microbiological assays conveys important diagnostic and therapeutic implications.展开更多
目的:探讨磁振磁电治疗仪联合前列倍喜胶囊治疗慢性前列腺炎/慢性骨盆疼痛综合征(CP/CPPS)的有效性及安全性。方法:采用前瞻性、双中心、随机、开放、阳性药物加载、平行对照的临床设计。将124例已确诊为CP/CPPS患者按数字表法随机分为...目的:探讨磁振磁电治疗仪联合前列倍喜胶囊治疗慢性前列腺炎/慢性骨盆疼痛综合征(CP/CPPS)的有效性及安全性。方法:采用前瞻性、双中心、随机、开放、阳性药物加载、平行对照的临床设计。将124例已确诊为CP/CPPS患者按数字表法随机分为对照组和观察组,每组62例,对照组服用前列倍喜胶囊,观察组在服用前列倍喜胶囊基础上联合磁振磁电治疗仪理疗,疗程14 d。治疗14 d结束后,比较两组治疗前后美国国立卫生研究院慢性前列腺炎症状指数(NIH-CPSI)评分及两组治疗总有效率;评估两组有效性和安全性。结果:两组治疗后的疼痛症状评分、排尿症状评分、生活质量评分及NIH-CPSI总评分均较治疗前明显改善(P<0.05);治疗后观察组的疼痛症状评分(7.34±3.26 vs 9.50±2.47)分、排尿症状评分(3.53±2.56 vs 4.50±2.35)分、生活质量评分(5.94±2.89 vs 8.03±2.60)分及总评分(16.65±7.90 vs 21.95±5.70)分均显著低于对照组,差异有统计学意义(P<0.05)。观察组临床总有效率为83.87%,明显高于对照组的53.23%,差异有统计学意义(P<0.05);治疗期间两组患者均无不良事件及不良反应发生,安全性评价为Ⅰ级。结论:磁振磁电治疗仪联合前列倍喜胶囊能显著缓解CP/CPPS患者的临床症状,疗效确切且安全性高,同时缩短治疗时间。展开更多
文摘We previously demonstrated the safety and efficacy of fluoroquinolone-macrolide combination therapy in category Ⅱ chronic bacterial prostatitis （CBP）. The aim of this study is to retrospectively compare the microbiological and clinical findings of two treatment schemes for CBP based on the combination of azithromycin （500 rag, thrice-weekly） with a once-daily 500- or 750-mg dose of ciprofloxacin （Cipro-500 or Cipro-750 cohort, respectively）. Combined administration of azithromycin （1500 mg week^-1） with ciprofloxacin at the rate of 750 mg day^- 1 for 4 weeks rather than at 500 mg day^- 1 for 6 weeks increased the eradication rates from 62.35% to 77.32% and the total bacteriological success from 71.76% to 85.57%. A significant decrease in pain and voiding signs/symptoms and a significant reduction in inflammatory leukocyte counts and serum prostate-specific antigen （PSA） were sustained throughout an 18-month follow-up period in both groups. Ejaculatory pain, haemospermia and premature ejaculation were significantly attenuated on microbiological eradication in both groups, but the latter subsided more promptly in the Cipro-750 cohort. In total, 59 Cipro-750 patients showed mild-to-severe erectile dysfunction （ED） at baseline, while 22 patients had no ED on microbiological eradication and throughout the follow-up period. In conclusion fluoroquinolone-macrolide therapy resulted in pathogen eradication and CBP symptom attenuation, including pain, voiding disturbances and sexual dysfunction. A once-daily 750-mg dose of ciprofloxacin for 4 weeks showed enhanced eradication rates and lower inflammatory white blood cell counts compared to the 500-mg dose for 6 weeks. Our results are open to further prospective validation.
文摘The significance and diagnostic value of semen analysis in chronic bacterial prostatitis has been extensively debated and remains controversial. To investigate the diagnostic relevance of semen culture in the bacteriological workup of prostatitis patients, we retrospectively analyzed a clinical database of 696 symptomatic patients. All patients were routinely subjected to a four-glass test, followed by semen culture and analysis. This allowed to dissect from the database three different diagnostic scenarios, and to compare the ＇two-glass＇ pre-/post- massage test and the standard ＇four-glass＇ test with a ＇five-glass＇ test （four-glass plus post-VB3 semen culture）. The ＇five-glass＇ test showed 3.6- or 6.5-fold increases in relative sensitivity and lesser reductions （-13.2% or -14.7%） in relative specificity for traditional uropathogens （TUs） compared with the four-glass or two-glass test, respectively. The area under the ROC curve and Jouden＇s index were increased, whereas positive and negative likelihood ratios were lower than comparators, indicating that the ＇five-glass＇ assay may be superior in confirming the negative outcome of both standard tests. The five-, four-, and two-glass tests detected TUs （Enterobacteriaceae, Enterococci, etc.） in 120, 33, and 20 patients and unusual pathogens （Streptococci, other Gram-positive species, Mycoplasmata, and others） in 130, 56, and 45 patients, respectively. When patients were subjected to pharmacological treatment, including a combination of a fluoroquinolone and a macrolide, no differences in eradication rates were observed between groups diagnosed with different tests, irrespective of pathogen category. Eradication was associated with long-term sign/symptom remission; no significant intergroup differences in sign/symptom scores were observed throughout a 24-month off-therapy follow-up period. In conclusion, our data support the usefulness of semen analysis in the diagnostic workup ofprostatitis patients when this test is used to complement the four-glass Meares and Stamey test. Improvement of microbiological assays conveys important diagnostic and therapeutic implications.
文摘目的:探讨磁振磁电治疗仪联合前列倍喜胶囊治疗慢性前列腺炎/慢性骨盆疼痛综合征(CP/CPPS)的有效性及安全性。方法:采用前瞻性、双中心、随机、开放、阳性药物加载、平行对照的临床设计。将124例已确诊为CP/CPPS患者按数字表法随机分为对照组和观察组,每组62例,对照组服用前列倍喜胶囊,观察组在服用前列倍喜胶囊基础上联合磁振磁电治疗仪理疗,疗程14 d。治疗14 d结束后,比较两组治疗前后美国国立卫生研究院慢性前列腺炎症状指数(NIH-CPSI)评分及两组治疗总有效率;评估两组有效性和安全性。结果:两组治疗后的疼痛症状评分、排尿症状评分、生活质量评分及NIH-CPSI总评分均较治疗前明显改善(P<0.05);治疗后观察组的疼痛症状评分(7.34±3.26 vs 9.50±2.47)分、排尿症状评分(3.53±2.56 vs 4.50±2.35)分、生活质量评分(5.94±2.89 vs 8.03±2.60)分及总评分(16.65±7.90 vs 21.95±5.70)分均显著低于对照组,差异有统计学意义(P<0.05)。观察组临床总有效率为83.87%,明显高于对照组的53.23%,差异有统计学意义(P<0.05);治疗期间两组患者均无不良事件及不良反应发生,安全性评价为Ⅰ级。结论:磁振磁电治疗仪联合前列倍喜胶囊能显著缓解CP/CPPS患者的临床症状,疗效确切且安全性高,同时缩短治疗时间。
