Fluoroquinolone (Quinolone) antibiotics. Clinical Uses. Part 2
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Prostatitis
Fluoroquinolones have been shown to penetrate into prostatic tissue in concentrations approaching or exceeding by severalfold those in serum (see preceding section). In the only comparative study, when each drug was given for 4 to 6 weeks, norfloxacin was shown to be more effective (P = 0.) than trimethoprim-sulfamethoxazole (TMP-SMX) for therapy of chronic bacterial prostatitis caused predominantly by E. coli. In two open studies also using prolonged therapy, norfloxacin and ciprofloxacin appeared to eradicate E. coli prostatitis in 85 to 92% of patients followed for at least 4 to 6 weeks after completion of therapy. Lower rates of eradication by ciprofloxacin have been associated with therapy given for only 2 weeks and with prostatitis caused by bacteria other than E. coli, including P. aeruginosa and enterococci. Pefloxacin has been reported to be effective in 21 of 31 cases (68%) of chronic prostatitis, with two of eight failures associated with the development of resistance. Acute prostatitis caused predominantly by enteric gram-negative bacilli was also cured at 7 months follow-up in 22 of 23 patients (96%) given ofloxacin (200 mg twice daily) from 24 to 90 days. Further studies are needed to define more fully the role of fluoroquinolones in the treatment of prostatitis.
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