A Switch Therapy Protocol with Intravenous Azithromycin and Ciprofloxacin Combination for Severe, Relapsing Chronic Bacterial Prostatitis: a Prospective Non-Comparative Pilot Study

Abstract

Chronic bacterial prostatitis (CBP) is characterized by intense clinical symptoms, frequent relapse episodes and poor quality of life. Aggressive antibacterial therapy is warranted to eradicate the causative pathogens and to achieve a permanent cure. We administered a "switch-therapy" protocol to 30 patients showing severe CBP symptoms and two or more relapse episodes in the previous 12 months. Patients received intravenous azithromycin (500 mg/day) and ciprofloxacin (800 mg/day) for 3 days, followed by oral ciprofloxacin (1 g/day) for 25 days. Twenty-seven (90%) patients showed pathogen eradication at test-of-cure (TOe) visit. Five cases of infectionrelapse were detected at follow-up. At the TOC visit, 25 patients (83%) showed mild/absent symptoms, measured with the NIH-chronicprostatitis symptom index. These results indicate the efficacyof a "switch-therapy" protocol, based on combined azithromycin and ciprofloxacin. Comparative studies on larger CBP patient populations are warranted to confirm these encouraging results.

Keywords:

• CHRONIC PROSTATITIS
• CHRONIC BACTERIAL PRO- STATITIS
• CHRONIC PELVIC PAIN SYNDROME
• MACROLIDE
• FLUORO- QUINOLONE
• GENITOURINARY INFECTIONS
• AZITHROMYCIN
• CIPROFLOXACIN
• NIH-CPSI