Excessive Antibiotic Use in Men with Prostatitis

Brent C. Taylor, Siamak Noorbaloochi, Mary McNaughton-Collins, Christopher S. Saigal, Min Woong Sohn, Michel A. Pontari, Mark S. Litwin, Timothy J. Wilt

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

Background: Prostatitis accounts for 2 million outpatient visits annually. The majority of prostatitis cases fit the definition of chronic pelvic pain syndrome, for which routine antibiotic use is not indicated. Methods: Inpatient, outpatient, and pharmacy datasets from the Veterans Health Administration were used to quantify the magnitude of antibiotic use attributable to chronic pelvic pain syndrome. Specifically, men with a diagnosis of infectious/acute prostatitis or a urinary tract infection were excluded, and the remaining men with a diagnosis of prostatitis were defined as having chronic pelvic pain syndrome. Results: The annual prevalence of chronic pelvic pain syndrome was 0.5%. Prescriptions for fluoroquinolone antibiotics were filled in 49% of men with a diagnosis of chronic pelvic pain syndrome compared with 5% in men without chronic pelvic pain syndrome. Men with chronic pelvic pain syndrome were more than 7 times more likely to receive a fluoroquinolone prescription independently of age, race/ethnicity, and comorbid conditions. Increased use of other antibiotics also was observed. High use was similar in men with either infectious/acute prostatitis or chronic pelvic pain syndrome. Conclusion: Despite evidence that antibiotics are not effective in the majority of men with chronic pelvic pain syndrome, they were prescribed in 69% of men with this diagnosis. Some increased use is probably due to uncontrolled confounding by comorbid conditions or inaccurate diagnostic coding. However, a 7-fold higher rate of fluoroquinolone usage suggests that strategies to reduce unnecessary antibiotic use in men with prostatitis are warranted.

Original languageEnglish (US)
Pages (from-to)444-449
Number of pages6
JournalAmerican Journal of Medicine
Volume121
Issue number5
DOIs
StatePublished - May 2008

Keywords

  • Antibiotics
  • Drug utilization
  • Male
  • Prostatitis

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