Zhuo Tony Su1, Jonathan Mark Zenilman2, Karen Sandell Sfanos1,3,4, Amin Sedaghat Herati5. 1. The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, 4940 Eastern Avenue, 301 Building, Suite 3112, Baltimore, MD, 21224, USA. 2. Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA. 3. Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA. 4. Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA. 5. The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, 4940 Eastern Avenue, 301 Building, Suite 3112, Baltimore, MD, 21224, USA. aherati1@jhmi.edu.
Abstract
PURPOSE OF REVIEW: We conducted a review of the literature describing the most up-to-date diagnosis and treatment options of chronic bacterial prostatitis. RECENT FINDINGS: Recurrence after oral antimicrobial therapy is common, due in part to the rising rates of antimicrobial resistance and inability to completely clear the offending bacteria from the prostate following prostatitis. Recent literature has described various treatment options for chronic bacterial prostatitis refractory to conventional antimicrobial agents, including the use of alternative agents such as fosfomycin, direct antimicrobial injections into the prostate, surgical removal of infected prostatic tissue, chronic oral antibiotic suppression, and an emerging novel therapy utilizing bacteriophages to target antibiotic resistant bacteria. Management of chronic bacterial prostatitis, especially recurrence after oral antimicrobial treatment, remains challenging. This review highlights an urgent need for further evidence assessing the efficacy and safety of treatment modalities for chronic bacterial prostatitis refractory to conventional oral antimicrobials.
PURPOSE OF REVIEW: We conducted a review of the literature describing the most up-to-date diagnosis and treatment options of chronic bacterial prostatitis. RECENT FINDINGS: Recurrence after oral antimicrobial therapy is common, due in part to the rising rates of antimicrobial resistance and inability to completely clear the offending bacteria from the prostate following prostatitis. Recent literature has described various treatment options for chronic bacterial prostatitis refractory to conventional antimicrobial agents, including the use of alternative agents such as fosfomycin, direct antimicrobial injections into the prostate, surgical removal of infected prostatic tissue, chronic oral antibiotic suppression, and an emerging novel therapy utilizing bacteriophages to target antibiotic resistant bacteria. Management of chronic bacterial prostatitis, especially recurrence after oral antimicrobial treatment, remains challenging. This review highlights an urgent need for further evidence assessing the efficacy and safety of treatment modalities for chronic bacterial prostatitis refractory to conventional oral antimicrobials.