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Approche pharmacocinétique du traitement antibiotique des infections génitales chroniques masculines

Andrologie volume 6, pages 228–233 (1996)Cite this article

Resume

Le traitement antibiotique des infections génitales chroniques masculines n'est pas satisfaisant car les guérisons sont obtenues moins d'une fois sur deux et les récidives sont fréquentes. La bonne connaissance des propriétés pharmacocinétiques des molécules activesin vitro sur les bactéries responsables de ce type d'infection permet de sélectionner pour le traitement de ces infections des antibiotiques diffusanta priori dans les voies génitales. Cependant les résultats des études faites chez l'animal sont difficilement exploitables. Le diagnostic d'une infection génitale chronique est difficile. La spermoculture ne permet pas toujours d'isoler une bactérie que l'on puisse mettre en cause et elle peut être négative même en cas d'infection bactérienne vraie. Le traitement sera si possible adapté, mais il sera souvent empirique. Les antibiotiques montrant une bonne efficacité (éradication du germe, disparition des symptômes) sont en nombre limité: cyclines, triméthoprime-sulfaméthoxazole, macrolides et fluoroquinolones. Ils devront être prescrits pour une période d'au moins 6 semaines.

Abstract

Antibiotherapy of chronic bacterial genital infection is not satisfactory as patients are cured in less than one case upon two and relapse is frequent. A good knowledge of pharmacokinetics of antibiotics with good activity in vitro against responsible bacteria is compulsory. In man, local diffusion of antibiotics is limited to prostatic tissue or secretions in noninfected individuals. No data are available in patients with chronic infection which are known to modify secretion parameters and could alter antibiotics diffusion. For pharmacological studies animal models are of limited help. Dog prostate is very different from men's one and secretion are very acidic but it is a very convenient model for obtaining prostatic secretions. Rat prostate is easily removed and may be infected experimentally. However, it is difficult to extrapolate the obtained results to human. Thus, antibiotic diffusion in male genital tract remains largely unknown. Ehtical reasons render more thorough investigations impossible. Antibiotherapy of chronic genital infection has to be adapted to isolated bacteria and must use drugs with a good local diffusion. However, this is difficult as cultures of semen and/or prostatic secretions do not always permit isolation of bacteria. Thus, the treatment is often empirical. Antibiotics with good efficacy (elimination of bacteria, regression of symptoms) are of limited number: cyclines, trimethoprim-sulfamethoxazole, macrolides and fluoroquinolones. They have to be administered for at least 6 weeks because of the chronic infectious process.

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Authors and Affiliations

  1. Laboratoire de Bactériologie, Hôpital Central, Nancy

    A. Lozniewski, V. Drouinot & M. Weber

  2. Laboratoire de Microbiologie, Hôpital de Brabois, CHU, Nancy

    A. Le Faou

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  4. A. Le Faou
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Lozniewski, A., Drouinot, V., Weber, M. et al. Approche pharmacocinétique du traitement antibiotique des infections génitales chroniques masculines. Androl. 6, 228–233 (1996). https://doi.org/10.1007/BF03034453

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Basic and Clinical Andrology

ISSN: 2051-4190