EFFICACY OF ENOXACIN IN THE TREATMENT OF PROSTATO-VESICULITIS - SAFETY ON SPERMATOGENESIS

Objectives: The ability of enoxacin, a second generation quinolone, to diffuse into the seminal fluid both of normal volunteers (n = 10, pro tocol A) and patients with prostato-vesiculitis and positive sperm cul tures (n = 10, protocol B) was investigated. In addition, the microbio logical effectiveness and the occurrence of adverse effects on spermat ogenesis were evaluated in the patient group. Methods: Enoxacin was ad ministered in oral doses of 300 mg b.i.d. for two and seven days to vo lunteers and patients, respectively. Two hours after the last drug adm inistration, blood, semen and urine samples were collected to determin e seminal fluid antibiotic concentrations by microbiological agar diff usion assay. In protocol B, sperm cultures and sperm analyses were per formed at the end of treatment and repeated at 30 and 90 days follow-u ps. Results: In both protocols significant seminal fluid antibiotic co ncentration was achieved, thus providing evidence for considerable dif fusion of the drug into prostate gland and seminal vesicles. Moreover, sperm cultures were sterile in all patients, and semen analysis demon strated that spermatogenesis was not impaired by antibiotic treatment; on the contrary, 30 days after drug withdrawal percentage sperm motil ity improved, and the rate of abnormal forms decreased. Conclusions: T he absence of adverse effects, both general and specifically on sperma togenesis, may be related to the restriction of indications and the br evity of the therapeutic cycles. Our results suggest that enoxacin may be successfully and safely used, in short term courses, for the treat ment of documented genital tract infection by sensitive organisms. Fur ther studies are needed to thoroughly evaluate the potential adverse e ffects on fertility of this quinolone, particularly when used for long -term suppressive therapy in patients with chronic urological infectio ns.