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Ciprofloxacin or tamsulosin in men with chronic prostatitis/chronic pelvic pain syndrome - A randomized, double-blind trial

Ciprofloxacin or tamsulosin in men with chronic prostatitis/chronic pelvic pain syndrome - A randomized, double-blind trial ANNALS OF INTERNAL MEDICINE Alexander, R. B., PROPERT, K. J., Schaeffer, A. J., Landis, J. R., Nickel, J. C., O'Leary, M. P., Pontari, M. A., McNaughton-Collins, M., Shoskes, D. A., Comiter, C. V., Datta, N. S., Fowler, J. E., Nadler, R. B., Zeitlin, S. I., Knauss, J. S., Wang, Y. L., Kusek, J. W., Nyberg, L. M., Litwin, M. S. 2004; 141 (8): 581-589

Abstract

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) in men is principally defined by pain in the pelvic region lasting more than 3 months. No cause of the disease has been established, and therapies are empirical and mostly untested. Antimicrobial agents and alpha-adrenergic receptor blockers are frequently used.To determine whether 6-week therapy with ciprofloxacin or tamsulosin is more effective than placebo at improving symptoms in men with refractory, long-standing CP/CPPS.Randomized, double-blind trial with a 2 x 2 factorial design comparing 6 weeks of therapy with ciprofloxacin, tamsulosin, both drugs, or placebo.Urology outpatient clinics at 10 tertiary care medical centers in North America.Patients were identified from referral-based practices of urologists. One hundred ninety-six men with a National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) score of at least 15 and a mean of 6.2 years of symptoms were enrolled. Patients had received substantial previous treatment.The authors evaluated NIH-CPSI total score and subscores, patient-reported global response assessment, a generic measure of quality of life, and adverse events. Interventions: Ciprofloxacin, 500 mg twice daily; tamsulosin, 0.4 mg once daily; a combination of the 2 drugs; or placebo.The NIH-CPSI total score decreased modestly in all treatment groups. No statistically significant difference in the primary outcome was seen for ciprofloxacin versus no ciprofloxacin (P = 0.15) or tamsulosin versus no tamsulosin (P > 0.2). Treatments also did not differ significantly for any of the secondary outcomes.Treatment lasting longer than 6 weeks was not tested. Patients who had received less pretreatment may have responded differently.Ciprofloxacin and tamsulosin did not substantially reduce symptoms in men with long-standing CP/CPPS who had at least moderate symptoms.

View details for Web of Science ID 000224652300001

View details for PubMedID 15492337