Bacterial Persistence in the Prostate After Antibiotic Treatment of Chronic Bacterial Prostatitis in Men With Spinal Cord Injury

ObjectiveTo investigate the microbiologic outcome after antibiotic treatment of bacterial prostatitis in men with spinal cord injury (SCI).MethodsA retrospective investigation was done in an SCI rehabilitation center. The microbiologic culture results of urine and ejaculate or prostatic fluid samples were collected from 34 men with SCI presenting with recurrent urinary tract infections and bacterial prostatitis. Furthermore, patient characteristics, bladder diary details, and the administered antibiotic treatment were collected.ResultsThe median age of the 34 investigated men was 42.5 years (lower quartile, 31.8; upper quartile, 46.1 years), and they had sustained SCI a median of 15.2 years (lower quartile, 4.7; upper quartile, 22.9 years) ago. The majority (24 of 34 patients; 71%) evacuated their bladder with intermittent catheterization. The most commonly used antibiotics to treat bacterial prostatitis were fluoroquinolones (n = 41) followed by trimethoprim-sulfamethoxazole (n = 8) and second-generation cephalosporins (n = 7). In merely 2 men, antibiotic treatment resulted in bacterial eradication from the prostate. A shift in the bacteria species identified in the ejaculate or prostatic fluid cultures was observed during the follow-up. Most men (28 of 34; 82%) presented with mostly the same bacteria (55 of 62, 89%) in the urine as in the ejaculate or prostate samples.ConclusionAntibiotic treatment did not result in the eradication of bacteria from the prostate of men with SCI. The antibiotic treatment of bacterial prostatitis in men with SCI should aim at eradicating symptoms and not bacteria.