본문 바로가기
KERD
논문KCI 등재

The Effect of α-Blockers Monotherapy vs. Combination Antibiotic Therapy on Symptom Alleviation in Patients with Chronic Prostatitis/Chronic Pelvic Pain Syndrome

Kyu Shik Kim|문홍상
대한요로생식기감염학회|2018.04|Urogenital Tract Infection|제13권 제1호|pp. 1-6|DOI 10.14777/uti.2018.13.1.1

2

조회

0

다운로드

0

인용

0

참고문헌

키워드

ProstatitisAnti-bacterial agentsMonotherapy
주제분류비뇨기과학

초록

Prostatitis is a pathologic state of prostate inflammation accompanied by lower urinary tract symptoms and pelvic pain, reducing the quality of life in males of all ages. There is currently no established treatment modality for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). In this review, alpha-blocker monotherapy was compared with combination antibiotic therapies. Alpha- blockers are the most commonly used medications to treat CPPS, administered to over 40% of CPPS patients. The use of antibiotics in CP/CPPS is an alternative treatment option. There are no studies showing the efficacy of antibiotics in CP/CPPS patients. However, antibiotics are commonly prescribed to patients with CP/CPPS, often leading to patient improvement. A combined regimen of alpha-blocker, antibiotic, and anti-inflammatory therapy showed improvement in patient symptoms; however, the results were similar to monotherapy with alpha-blockers. When alpha-blocker monotherapy was compared with three multidrug therapies via randomized controlled trials, monotherapy was shown to be more effective than multidrug treatment. There is no definite treatment for CP/CPPS because it is caused by various factors, and symptoms are different for each patient. CP/CPPS patient care should be managed in a manner that identifies and treats all symptoms simultaneously and appropriately. Recently, urinary, psychosocial, organ-specific, infection, neurologic/systemic, and tenderness (UPOINT) was introduced in order to better treat patients. However, UPOINT has not been extensively studied in clinical trials, and the mechanical principles of UPOINT have yet to be elucidated. Alpha-blocker monotherapy and antibiotic combination therapy showed considerable improvement in CP/CPPS patients (by National Institutes of Health Chronic Prostatitis Symptom Index scores).

Abstract

Prostatitis is a pathologic state of prostate inflammation accompanied by lower urinary tract symptoms and pelvic pain, reducing the quality of life in males of all ages. There is currently no established treatment modality for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). In this review, alpha-blocker monotherapy was compared with combination antibiotic therapies. Alpha- blockers are the most commonly used medications to treat CPPS, administered to over 40% of CPPS patients. The use of antibiotics in CP/CPPS is an alternative treatment option. There are no studies showing the efficacy of antibiotics in CP/CPPS patients. However, antibiotics are commonly prescribed to patients with CP/CPPS, often leading to patient improvement. A combined regimen of alpha-blocker, antibiotic, and anti-inflammatory therapy showed improvement in patient symptoms; however, the results were similar to monotherapy with alpha-blockers. When alpha-blocker monotherapy was compared with three multidrug therapies via randomized controlled trials, monotherapy was shown to be more effective than multidrug treatment. There is no definite treatment for CP/CPPS because it is caused by various factors, and symptoms are different for each patient. CP/CPPS patient care should be managed in a manner that identifies and treats all symptoms simultaneously and appropriately. Recently, urinary, psychosocial, organ-specific, infection, neurologic/systemic, and tenderness (UPOINT) was introduced in order to better treat patients. However, UPOINT has not been extensively studied in clinical trials, and the mechanical principles of UPOINT have yet to be elucidated. Alpha-blocker monotherapy and antibiotic combination therapy showed considerable improvement in CP/CPPS patients (by National Institutes of Health Chronic Prostatitis Symptom Index scores).

참고문헌 (34)

  1. Yoon BI, "Acute bacterial prostatitis: how to prevent and manage chronic infection?", J Infect Chemother, 18, pp.444~450 (2012)[DOI]
  2. de la Rosette JJ, "Diagnosis and treatment of 409 patients with prostatitis syndromes", Urology, 41, pp.301~307 (1993)[DOI]
  3. Schaeffer AJ, "The efficacy of norfloxacin in the treatment of chronic bacterial prostatitis refractory to trimethoprim-sulfamethoxazole and", or carbenicillin, 1990, pp.144, 690~693
  4. Pust RA, "Clinical efficacy of ofloxacin (tarivid) in patients with chronic bacterial prostatitis: preliminary results", J Chemother, 1(4 Suppl), pp.869~871 (1989)
  5. Nickel JC, "Treatment of chronic prostatitis", chronic pelvic pain syndrome, 2008, pp.31(Suppl 1), S112~S116
  6. Schaeffer A, "Male lower urinary tract dysfunction, evaluation and management. 6th International Consultation on New Developments in Prostate Cancer and Prostate Disease", pp.341~385 (2006), Health Publications
  7. Zhu QF, "Detection of bacterial signal of 16S rRNA gene in prostate tissues obtained by perineal approach from patient with chronic pelvic pain syndrome", Zhonghua Yi Xue Za Zhi, 89, pp.823~825 (2009)
  8. Bergner M, "The sickness impact profile: validation of a health status measure", Med Care, 14, pp.57~67 (1976)[DOI]
  9. Schneider H, "Prostate-related pain in patients with chronic prostatitis", chronic pelvic pain syndrome, 2005, pp.95, 238~243
  10. Ku JH, "Epidemiologic risk factors for chronic prostatitis", Int J Androl, 28, pp.317~327 (2005)[DOI]
  11. Nickel JC, "Prostatitis: lessons from the 20th century", BJU Int, 85, pp.179~185 (2000)[DOI]
  12. Schaeffer AJ, "Demographic and clinical characteristics of men with chronic prostatitis: the national institutes of health chronic prostatitis cohort study", J Urol, 168, pp.593~598 (2002)[DOI]
  13. Trevisani M, "The influence of alpha1-adrenoreceptors on neuropeptide release from primary sensory neurons of the lower urinary tract", Eur Urol, 52, pp.901~908 (2007)[DOI]
  14. Schwinn DA, "Alpha1-adrenoceptor subtypes and lower urinary tract symptoms", Int J Urol, 15, pp.193~199 (2008)[DOI]
  15. Mehik A, "Alfuzosin treatment for chronic prostatitis", chronic pelvic pain syndrome: a prospective, randomized, double-blind, placebo-controlled, pilot study, 2003, pp.62, 425~429
  16. Nickel JC, "Alfuzosin and symptoms of chronic prostatitis-chronic pelvic pain syndrome", N Engl J Med, 359, pp.2663~2673 (2008)[DOI]
  17. Nickel JC, "Silodosin for men with chronic prostatitis", chronic pelvic pain syndrome: results of a phase II multicenter, double-blind, placebo controlled study, 2011, pp.186, 125~131
  18. Nickel JC, "Treatment of chronic prostatitis", chronic pelvic pain syndrome with tamsulosin: a randomized double blind trial, 2004, pp.171, 1594~1597
  19. Chen Y, "Effects of a 6-month course of tamsulosin for chronic prostatitis", chronic pelvic pain syndrome: a multicenter, randomized trial, 2011, pp.29, 381~385
  20. Tugcu V, "A placebo-controlled comparison of the efficiency of triple- and monotherapy in category III B chronic pelvic pain syndrome (CPPS)", Eur Urol, 51, pp.1113~1117 (2007)[DOI]
  21. Cheah PY, "Initial, long-term, and durable responses to terazosin, placebo, or other therapies for chronic prostatitis", chronic pelvic pain syndrome, 2004, pp.64, 881~886
  22. Cheah PY, "Terazosin therapy for chronic prostatitis", chronic pelvic pain syndrome: a randomized, placebo controlled trial, 2003, pp.169, 592~596
  23. Shoskes DA, "Use of antibiotics in chronic prostatitis syndromes", Can J Urol, 8(Suppl 1), pp.24~28 (2001)
  24. Schaeffer AJ. Clinical practice, "Chronic prostatitis and the chronic pelvic pain syndrome", N Engl J Med, 355, pp.1690~1698 (2006)[DOI]
  25. Nickel JC, "Management of chronic prostatitis", chronic pelvic pain syndrome (CP, World J Urol, pp.2013, 31[DOI]
  26. Nickel JC, "Levofloxacin for chronic prostatitis", chronic pelvic pain syndrome in men: a randomized placebo-controlled multicenter trial, 2003, pp.62, 614~617
  27. Zhou Z, "Detection of nanobacteria infection in type III prostatitis", Urology, 71, pp.1091~1095 (2008)[DOI]
  28. Engeler D, "Guidelines on chronic pelvic pain", European Association of Urology (2012)
  29. Nickel JC, "Predictors of patient response to antibiotic therapy for the chronic prostatitis", chronic pelvic pain syndrome: a prospective multicenter clinical trial, 2001, pp.165, 1539~1544
  30. Ye ZQ, "Tamsulosin treatment of chronic non-bacterial prostatitis", J Int Med Res, 36, pp.244~252 (2008)[DOI]
  31. Alexander RB, "Ciprofloxacin or tamsulosin in men with chronic prostatitis", chronic pelvic pain syndrome: a randomized, double-blind trial, 2004, pp.141, 581~589
  32. Jeong CW, "Treatment for chronic prostatitis", chronic pelvic pain syndrome: levofloxacin, doxazosin and their combination, 2008, pp.80, 157~161
  33. 김태효, "Tamsulosin Monotherapy versus Combination Therapy with Antibiotics or Anti-Inflammatory Agents in the Treatment of Chronic Pelvic Pain Syndrome", International Neurourology Journal, 15(2), pp.92~96 (2011), 대한배뇨장애요실금학회
  34. Shoskes DA, "Clinical phenotyping in chronic prostatitis", chronic pelvic pain syndrome and interstitial cystitis: a management strategy for urologic chronic pelvic pain syndromes, 2009, pp.12, 177~183

이 간행물의 다른 논문 (2건)

Lactobacillus and Urine Microbiome in Association with Urinary Tract Infections and Bacterial Vaginosis김준모, Yoo-Jin Parkpp. 7-13Epidemiology and Outcomes of Acute Flank Pain in University-Affiliated Regional Emergency Medical CentersSeung Chol Park, 이재환, Seon Tae Kim, 황용pp. 14-20
원문 보기