The role of lomefloxacin in the treatment of chronic prostatitis

The choice of antimicrobial agents for treatment of prostatitis should be b ased on two factors: in vitro sensitivity of isolated pathogens and potenti al intraprostatic penetration of the molecule. Unfortunately, only a few an tibiotic agents penetrate prostatic fluid which is the primary site of infe ction. Lomefloxacin, a once-daily difluoroquinolone, could play a central r ole in the therapy of prostatitis because it has sufficient liposolubility, low ionization (pKa), low protein binding, small molecular size, long seru m elimination half-life and it can pass from interstitial fluid across pros tatic cells into the lumen. This study was carried out on 12 patients (mean age 65 years) with normal h epatic and renal function, divided into two groups of 6 subjects each. Lome floxacin was administered for perioperative antisepsis at the dose of 400 m g orally once a day for 4 days. Serum and tissue were sampled in the two gr oups of patients 4 h (Group A) and 8 h (Group B) respectively after the las t drug administration. Tissue penetration was higher than serum, with a T/S >2 in the prostatic capsule and seminal blister, and a T/S >1.6 in the ade nomatous tissue, in both groups of patients. In addition, the prostatic tis sue concentrations exceeded the MIC for the main pathogens usually involved in urogenital infections. Therefore, because of its pharmacokineitic and p harmacodynamic characteristics, lomeflloxacin is proposed as an efficacious therapeutic option, even for the treatment of chronic prostatitis.