Diffusion of cefmenoxime into prostatic fluid in the patients with acute bacterial prostatitis
Katoh, N.; Sugiyama, T.; Ono, Y.; Hirabayashi, S.
Hinyokika Kiyo. Acta Urologica Japonica 36(11): 1287-1293
1990
ISSN/ISBN: 0018-1994 PMID: 2288308 Document Number: 365380
Expressed prostatic fluid (EPS) levels and serum levels of cefmenoxime (CMX) after intravenous administration were examined in 16 patients with acute bacterial prostatitis and 23 patients without prostatic diseases. Blood was drawn at 30, 60, 120 minutes and EPS was taken by prostatic massage at 60 minutes after the intravenous administration of 2 g CMX to evaluate the concentration of CMX. The concentration of CMX was determined by the bioassay using the E. coli NIHJ JC strain. The relationships between the EPS/serum ratio and peripheral WBC counts, CRP value and ESR1h value were also analyzed. The serum levels of CMX at 60 minutes ranged between 20.3 .mu.g/ml and 73.5 .mu.g/ml (mean .+-. S.D.: 41.8 .+-. 14.2 .mu.g/ml) in 16 patients with acute prostatitis, and between 21.5 .mu.g/ml and 89.5 .mu.g/ml (mean .+-. S.D.: 49.5 .+-. 18.7 .mu.g/ml) in 23 patients without prostatic diseases. The EPS levels ranged between 0.4 .mu.g/ml and 30.8 .mu.g/ml (mean .+-. S.D.: 12.6 .+-. 9.6 .mu.g/ml) in 16 patients with acute prostatitis, and between 0 and 2.3 .mu.g/ml (mean .+-. S.D.: 0.7 .+-. 0.8 .mu.g/ml) in 19 patients without prostatic diseases. In 4 patients without prostatic diseases, the EPS amount was not large enough to evaluate the concentration of CMX. The EPS/serum ratio ranged between 0.006 and 0.697 (mean .+-. S.D.: 0.31 .+-. 0.21) in patients with acute prostatitis and between 0 and 0.058 (mean .+-. S.D.: 0.015 .+-. 0.018) in patients without prostatic diseases. The diffusion of CMX into the prostatic fluid in patients with acute prostatitis was strikingly higher than that in patients without prostatic diseases (p < 0.01). The CMX concentrations of prostatic fluid was enough to control the growth of the CMX-sensitive bacteria in the acute prostatitis patients. ESR 1 h value was correlated well to the EPS/serum ratio in acute prostatitis patients (p < 0.01). However, the number of WBC in peripheral blood and CRP value was not correlated to the EPS/serum ratio in acute prostatitis patients (p > 0.05, p > 0.05). CMX might be expected to penetrate into the prostatic fluid according to the grade of the inflammation of prostate.