Prostatitis
Bacteria and Prostatitis
Diagnosis and Treatment of Prostatitis
Prostatitis is perianal and lower urinary tract symptoms in men. Prostatitis is a common problem in older males. It may be classified into three distinct types: acute bacterial prostatitis, chronic bacterial prostatitis and nonbacterial prostatitis. Since the prostate is a privileged site, the efficacy of antimicrobial agents is limited, a long duration of treatment is required, and failure rates are high. As a result, the diagnosis and therapy of prostatitis remains a challenge.
Acute Bacterial Prostatitis
Acute bacterial prostatitis (ABP) is usually accompanied by a urinary tract infection with positive cultures from prostatic secretions. Symptoms include sudden onset of fever, chills, and low back and perianal pain.
Patients often complain of obstructive (dysuria, nocturia, urgency, frequency, and burning) and irritative (hesitancy, straining, dribbling, weak stream, and incomplete emptying) urinary symptoms. Physical examination reveals a warm, tender, swollen and indurated prostate.In patients who present with a recent history of hospitalization and/or broad-spectrum antimicrobial use, a high index of suspicion for Pseudomonal, Enterococcal and Staphylococcal infections should be maintained. Other microorganisms implicated in prostatitis include Chlamydia trachomatis, Ureaplasma urealyticum, and Corynebacterium seminale.
The duration of treatment for acute bacterial prostatitis is mostly suggest 4–6 weeks of therapy.
Chronic Bacterial Prostatitis
Chronic bacterial prostatitis (CBP) occurs when acute bacterial prostatitis is treated inadequately due to resistance, relapse, short-course therapy. The most common clinical feature of CBP is recurrent urinary tract infections. Subsequently, patients will complain of obstructive and irritative urinary symptoms.
Spicy foods, caffeine, and alcohol should be avoided; they may cause bladder irritation and spasms culminating in reflux of urine into prostatic ducts, thus exacerbating nonbacterial prostatitis symptoms.
Conclusion
Since prostatitis tends to require prolonged therapy, patients must understand the importance of compliance.Treatment of prostatitis is associated with high failure rates; therefore it is paramount that pharmacists counsel patients regarding prostatitis and its treatment. Furthermore, pharmacists play a vital role in referring patients who are unresponsive to therapy for evaluation of serious underlying conditions. Pharmacists must carefully screen for drug interactions that may decrease compliance and efficacy.
