만성 전립선염에 대한 Levofloxacin의 경구 치료효과
The Efficacy of Oral Levofloxacin in the Treatment of Patient with Chronic Prostatitis
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목 적 : 전립선액검사상 염증소견을 보이는 만성전립선염 환자에서 일차적 치료제로 흔히 사용되는 항생제 중 levofloxacin의 임상적 치료효능에 대해 알아보았다.재료 및 방법 : 2000년 3월부터 2002년 2월까지 전립선액검사상 염증소견이 있는 만성전립선염으로 치료받은 환자 중 임상증상과 전립선액검사(EPS)의 추적 관찰이 가능한 64명에게 경구로 levofloxacin(Cravit ) 200 mg을 1일 2회씩 투여하였다. EPS와 만성전립선염증상점수(NIH-CPSI)를 치료후 3개월에 각각 재평가 하였다.결 과 : 전립선액배양 검사로 16명(25%)에서 균이 동정(NIH-category Ⅱ)되었으며, 48명(75%)에서는 균은 동정되지 않았으나 전립선액검상 의미있는 백혈구의 증가소견(NIH-category Ⅲa)을 보였다. Category Ⅱ에서 치료전과 치료 후의 CPSI는 각각 24.9±4.7, 14.1±6.5이였고, category Ⅲa에서 CPSI는 치료전후 각각 23.92±4.4, 13.2±5.7였다. Category Ⅱ, Ⅲa 모두에서 치료후 유의한 임상호전을 보였다(P<0.01, P<0.01). 치료후 EPS에서 고배율시야상 백혈구가 10개 이하로 효과적인 감소를 보인 경우는 전체에서 23명(35.9%)으로서 category Ⅱ에서 6명(37.5%), category Ⅲa에서 17명(35.4%)이었다. 치료 중 부작용은 경미한 가려움증을 호소하는 경우가 1례에서 있었다. 결 론:만성전립선염환자에서 levofloxacin 1일 400 mg 경구투여는 만성전립선염에서 CPSI의 호전에 효과적이지만, 전립선액에서 백혈구감소는 저명하지 않았다.
Abstract
Purpose:Antibiotic is widely used in the treatment of chronic prostatitis. In this study, we evaluated the clinical efficacy and safety of levofloxacin (CravitⓇ) in the treatment of patients with chronic prostatitis. Materials and Methods:Between March 2001 and February 2003, 64 patients with chronic bacterial (NIH-category Ⅱ) and nonbacterial inflammatory prostatitis (NIH-category Ⅲa) were enrolled in this study. Daily 400 mg of levofloxacin was administered orally for 4-18 weeks. To determine the efficacy of levofloxacin, patients were assessed with the NIH-CPSI and examined of expressed prostatic secretion (EPS) at 3 months follow-up period. Results:The CPSI of 16 patients stratified into NIH-category Ⅱ was 24.9±4.7 before and 14.1±6.5 after the treatment. For 48 patients stratified into NIH-category Ⅲa, the CPSI value before and after the treatment was 23.9±4.4 and 13.2±5.7, respectively. 40 patients (62.5%) showed mild to moderate improvement in NIH-CPSI, and 23 patients (35.9%) showed improvement in the laboratory profile according to the count of leukocytes (WBC <10/HPF) in EPS. Adverse reaction was noted in 1 patient during the treatment. Conclusions:This study shows that levofloxacin may be a safe and effective agent in treating either chronic bacterial prostatitis or chronic nonbacterial inflammatory prostatitis with few adverse reactions.
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