The efficacy of antibiotic and alpha-blocker combination therapy versus antibiotic monotherapy in chronic prostatitis/chronic pelvic pain syndrome: A systematic review

IF 1.5 4区医学 Q3 UROLOGY & NEPHROLOGY LUTS: Lower Urinary Tract Symptoms Pub Date : 2023-04-02 DOI:10.1111/luts.12477

Fina Widia, Widi Atmoko, Natanael Parningotan Agung, Harrina Erlianti Rahardjo, Nur Rasyid, Ponco Birowo, Akmal Taher

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Abstract

Objectives

This study attempted to explore the efficacy of a combination of alpha-blockers and antibiotics compared with antibiotic monotherapy in patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).

Methods

We searched PubMed/MEDLINE, Cochrane/CENTRAL, EBSCOHost/CINAHL, ProQuest, and Scopus on January 2020. Randomized controlled trials comparing antibiotic monotherapy with combination therapy of antibiotics and alpha-blockers in CP/CPPS patients lasting at least 4 weeks were included. The study eligibility assessment, data extraction, and study quality assessment were carried out by each author independently and in duplication.

Results

A total of six low- to high-quality studies with 396 patients were included in the study. Two reviews reported lower National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) total scores in the monotherapy arm at Week 6. Only one study reported otherwise. On Day 90, the NIH-CPSI score was found to be lower in the combination group. In the pain, urinary, and quality-of-life domain, most studies agree that combination therapy is not superior to monotherapy. However, on Day 90, all domains were found to be lower in the combination therapy. Responder rates were found to vary between studies. Only four out of six studies reported a response rate. Responder rates were lower in the combination group at 6 weeks of observation. On Day 90, responder rates were found to be better in the combination group.

Conclusions

The combination therapy of antibiotics and alpha-blockers is not substantially better than antibiotic monotherapy in the first 6 weeks of treatment for CP/CPPS patients. This might not be applicable to a longer duration of treatment.

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抗生素和α受体阻滞剂联合治疗与抗生素单药治疗慢性前列腺炎/慢性盆腔疼痛综合征的疗效:系统综述

目的探讨α -受体阻滞剂联合抗生素治疗慢性前列腺炎/慢性盆腔疼痛综合征(CP/CPPS)的疗效，并与抗生素单药治疗进行比较。方法于2020年1月检索PubMed/MEDLINE、Cochrane/CENTRAL、EBSCOHost/CINAHL、ProQuest和Scopus。在CP/CPPS患者中，比较抗生素单药治疗与抗生素和α受体阻滞剂联合治疗持续至少4周的随机对照试验。研究合格性评估、数据提取和研究质量评估由每位作者独立完成，并重复进行。结果本研究共纳入6项低质量到高质量的研究，共纳入396例患者。两篇综述报道，在第6周，单药治疗组的美国国立卫生研究院慢性前列腺炎症状指数(NIH-CPSI)总分较低。只有一项研究与此相反。在第90天，发现联合组的NIH-CPSI评分较低。在疼痛、泌尿和生活质量方面，大多数研究一致认为联合治疗并不优于单一治疗。然而，在第90天，发现联合治疗的所有域都较低。研究发现应答率在不同的研究中有所不同。六项研究中只有四项报告了反应率。观察6周时，联合用药组的应答率较低。在第90天，发现联合组的应答率更好。结论在CP/CPPS患者治疗的前6周，抗生素与α受体阻滞剂联合治疗并不明显优于抗生素单药治疗。这可能不适用于较长时间的治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

LUTS: Lower Urinary Tract Symptoms UROLOGY & NEPHROLOGY-

CiteScore

3.00

自引率

7.70%

发文量

审稿时长

>12 weeks

期刊介绍： LUTS is designed for the timely communication of peer-reviewed studies which provides new clinical and basic science information to physicians and researchers in the field of neurourology, urodynamics and urogynecology. Contributions are reviewed and selected by a group of distinguished referees from around the world, some of whom constitute the journal''s Editorial Board. The journal covers both basic and clinical research on lower urinary tract dysfunctions (LUTD), such as overactive bladder (OAB), detrusor underactivity, benign prostatic hyperplasia (BPH), bladder outlet obstruction (BOO), urinary incontinence, pelvic organ prolapse (POP), painful bladder syndrome (PBS), as well as on other relevant conditions. Case reports are published only if new findings are provided. LUTS is an official journal of the Japanese Continence Society, the Korean Continence Society, and the Taiwanese Continence Society. Submission of papers from all countries are welcome. LUTS has been accepted into Science Citation Index Expanded (SCIE) with a 2011 Impact Factor.