Antibiotic therapy effectiveness as an outcome predictor of complex treatment in chronic prostatitis/chronic pelvic pain syndrome.

Introduction: We hypothesized that the history of antibiotic efficacy was related to the outcome of the treatment of patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and evaluated this as a phenotyping factor for such patients.

Material And Methods: This prospective study included 74 patients with CP/CPPS aged 18-45 years old, who had at least 10 points on the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) scale and did not receive treatment for CP/CPPS for the last 3 months. There were 5 visits. Group 1 (n = 37) included patients with past successful antibiotic therapy. Group 2 (n = 37) included patients without antibiotic effect. All patients orally received: diclofenac sodium (100 mg/day, 2 weeks), modified release tamsulosin (0.4 mg/day, 1 month), and alcohol extract of Serenoa repens (320 mg/day, 6 months). Patients were monitored for symptoms of chronic prostatitis, depression, anxiety, and correlates of inflammation.

Results: After the treatment, NIH-CPSI scores significantly decreased (6 points or more) in Groups 1 and 2. The depression and anxiety symptoms significantly decreased only in Group 2. In Group 1, the efficacy of treatment was in 59.5% and 51.4% of patients, and in Group 2 - 83.8% and 78.4% at visits V2 and V4, respectively. The efficacy was significantly (p <0.05) lower in Group 1. The history of antibiotic efficacy and the outcome of this study treatment were significantly related (p <0.05).

Conclusions: For CP/CPPS, the history of antibiotic efficacy determines the prognosis of current treatment. The latent bacterial factor is assumed in 24.3-27% of cases of CP/CPPS.