%0 Journal Article
%T Acute bacterial prostatitis: heterogeneity in diagnostic criteria and management. Retrospective multicentric analysis of 371 patients diagnosed with acute prostatitis
%A Manuel Etienne
%A Pascal Chavanet
%A Louis Sibert
%A Fr¨¦d¨¦ric Michel
%A Herv¨¦ Levesque
%A Bernard Lorcerie
%A Jean Doucet
%A Pierre Pfitzenmeyer
%A Fran£¿ois Caron
%J BMC Infectious Diseases
%D 2008
%I BioMed Central
%R 10.1186/1471-2334-8-12
%X The symptoms, investigations and treatments of 371 inpatients diagnosed with AP were analyzed through a retrospective study conducted in four departments ¨C Urology (U), Infectious Diseases (ID), Internal Medicine (IM), Geriatrics (G) ¨C of two French university hospitals.The cause of admission, symptoms, investigations and treatments depended markedly on the department of admission but not on the hospital. In U, patients commonly presented with a bladder outlet obstruction, they had a large imaging and functional check-up, and received alpha-blockers and anti-inflammatory drugs. In ID, patients were febrile and received longer and more appropriate antibiotic treatments. In G, patients presented with cognitive disorders and commonly had post-void urine volume measurements. In IM, patients presented with a wide range of symptoms, and had very diverse investigations and antibiotic regimen.Overall, a 3:1 ratio of community-acquired AP (CA-AP) to nosocomial AP (N-AP) was observed. Urine culture isolated mainly E. coli (58% of AP, 68% of CA-AP), with venereal agents constituting less than 1%. The probabilistic antibiotic treatments were similar for N-AP and CA-AP (58% bi-therapy; 63% fluoroquinolone-based regimen). For N-AP, these treatments were more likely to be inadequate (42% vs. 8%, p < 0.001) and had a higher rate of bacteriological failure (48% vs. 19%, p < 0.001).Clinical failure at follow-up was more common than bacteriological failure (75% versus 24%, p < 0.001). Patients older than 49 had more underlying urinary tract disorders and a higher rate of clinical failure (30% versus 10%, p < 0.0001).This study highlights the difficulties encountered on a daily basis by the physicians regarding the diagnosis and management of acute prostatitis.There is a current lack of agreement upon guidelines for the diagnosis and treatment of male urinary tract infections (UTI), in particular concerning acute prostatitis (AP). Indeed, the current NIH classification of prostatitis p
%U http://www.biomedcentral.com/1471-2334/8/12