Multimodal Therapy in Multidrug-Resistant Prostatitis: A Case Report and Review of the Literature

Cureus. 2024 Nov 19;16(11):e74025. doi: 10.7759/cureus.74025. eCollection 2024 Nov.

Abstract

Chronic bacterial prostatitis is generally difficult to treat. It may involve multiple courses of antibiotics and may be difficult to eradicate with high rates of recurrence. We present the case of a 33-year-old male patient with a previous history of renal tract calculi, stent insertions, and perinephric abscess with percutaneous drainage, which then led to a right nephrectomy. He eventually developed recurrent urinary tract infections with the prostate as the source. This patient had at least two prior, prolonged courses of intravenous antibiotics, one consisted of two weeks and the other of six weeks of intravenous meropenem at different times. His last episode of prostatitis was managed with intraprostatic injections of lidocaine and a mixture of amikacin and meropenem, given at once-a-week intervals for four weeks along with simultaneous thrice-daily meropenem during this period.

Keywords: antimicrobial resistance; chronic bacterial prostatitis; injection therapy of prostatitis; intra-prostatic antibiotics; intra-prostatic injections; multidrug-resistant prostatitis; recurrent resistant prostatitis.

Publication types

  • Case Reports