NEW YORK (Reuters Health) - Neither the quinolone antibiotic ciprofloxacin nor the alpha-adrenergic receptor antagonist tamsulosin relieves symptoms of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) after 6 weeks of treatment, results of a multicenter study suggest.

Antimicrobials and alpha-blockers are the two most common treatments prescribed for CP/CPPS, Dr. Richard B. Alexander, from the University of Maryland School of Medicine in Baltimore, and members of the Chronic Prostatitis Collaborative Research Network report in the October 19th issue of the Annals of Internal Medicine. Whether they relieve symptoms has yet to be established.

The study included 174 men with symptoms of at least 3 months' duration treated at one of 10 tertiary medical centers in North America. National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) scores were at least 15 out of a possible 43. Forty-two patients were assigned to ciprofloxacin 500 mg b.i.d., 45 to tamsulosin 0.4 mg q.d., 42 to combination treatment and 45 to placebo.

All four treatment groups improved approximately 3 to 6 points over the 6-week course of treatment, with no significant differences between groups. There were no significant changes between week 6 and week 12, or in the subcategories of pain, urinary symptoms or quality of life scores.

"Our data do not support the use of these agents as empirical therapy for men with long-standing CP/CPPS and at least moderate symptoms," concludes Dr. Alexander's group.

However, "patients with new diagnoses who are given longer courses of the trial treatments might respond differently," they add.

In an accompanying editorial, Dr. Wolfgang Weidner agrees with the Network's conclusion that antibiotics are not useful for treatment of CP/CPPS.

However, adds Dr. Weidner, a urologist at the University of Giessen in Germany, "I don't think a firm conclusion can be drawn about the effectiveness of alpha-blockers," since other published studies showed a favorable effect. He believes that a longer trial, lasting 3 to 6 months, "is a reasonable intervention" for patients with refractory symptoms.

Ann Intern Med 2004;141:581-589,639-640.

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