Safety considerations with new antibacterial approaches for chronic bacterial prostatitis.

Chronic bacterial prostatitis (CBP) is a difficult-to-eradicate infection. Antibacterial therapy with currently licensed agents is hindered due to the increasing emergence of pathogen resistance worldwide and to frequent infection relapse. With limited treatment options, physicians are investigating new agents, which however may raise safety concerns.Areas covered: Antibacterial agents currently licensed for CBP were not considered. Available reports about safety and efficacy of antibacterial agents that have been clinically tested or tentatively used to treat CBP in single cases were evaluated. This review also focused on agents targeting Gram-positive pathogens, whose prevalence as causative agents of CBP is increasing.Expert opinion: (i) Most antibacterial agents considered in this review have been administered off-label in the interest of patients, and their use requires particular caution. (ii) Reports describing the usage of many of the drugs reviewed here are still scant, and readers should be warned of the limited published evidence supporting therapy of CBP with these agents. (iii) As treatment must extend over several weeks, medium-term adverse events may occur and therapy should be individualized, taking into account the dosage and the potential toxicity of each specific antibiotic. Regarding dangerous drug-drug interactions, particular attention should be paid to the risk of ECG-QT-interval elongation.

Expert opinion on drug safety. 2021 Jul 14 [Epub ahead of print]

Gianpaolo Perletti, Alberto Trinchieri, Konstantinos Stamatiou, Vittorio Magri

Department of Biotechnology and Life Sciences, Section of Medical and Surgical Sciences, University of Insubria, 21100 Varese, Italy., Department of Urology, IRCCS Ca' Granda Ospedale Maggiore Policlinico - University of Milan, 20122 Milan, Italy., Urology Department, Tzaneio General Hospital, 18536 Piraeus, Greece., Urological clinic, ASST North, 20026 Milan, Italy.

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