Usage and Dosage of Fosfomycin for NIH Category II Chronic Bacterial Prostatitis

Chronic bacterial prostatitis (CBP, NIH category II) is a difficult- to-eradicate, recurring, chronic infection of the prostate, often characterized by disabling symptoms, significantly reducing the quality of life of patients. Fluoroquinolones have been for many years first-line agents for treatment of this condition. However, mounting pathogen resistance trends (especially in Mediterranean countries like Greece and Italy) are progressively restricting the usage of fluoroquinolones for treating many Gram-positive or Gram-negative infections in the urological field, and clinicians are increasingly treating bacterial prostatitis by empirically administering agents which have not been adequately tested in the frame of clinical trials. In recent years, reports on the efficacy of the bactericidal antibiotic fosfomycin on CBP have been published. Most articles published so far are case reports, and only few case series or cohort studies are available. The aim of this article is to review the information published so far concerning the usage and dosage of fosfomycin for treatment of chronic bacterial prostatitis.