The spectrum of pathogens causing
chronic bacterial prostatitis comprises Gram-negative, Gram-positive and atypical microorganisms. Because of its broad spectrum of activity, the group 4
fluoroquinolone moxifloxacin might be a suitable
antibiotic for treatment of bacterial
prostatitis. The aim of this prospective study was to investigate the penetration of
moxifloxacin into prostatic tissue in patients with
benign prostatic hyperplasia. Patients received a single dose of
moxifloxacin 400 mg in
an 1 hour lasting infusion (250 ml) for perioperative prophylaxis before undergoing transurethral resection of the prostate (
TURP). Serum concentrations were determined in all patients before infusion, at the end of infusion (time point 0), 0.5, 1 and 2 h after the end of infusion. Patients were randomized for tissue sampling either 0, 0.5, 1 or 2 h after the end of infusion. At beginning of
TURP approximately 1 g of tissue was sampled for analysis. Concentrations of
moxifloxacin in serum and tissue were determined by HPLC. 39 patients were evaluated. Median serum and prostatic tissue concentrations peaked at 0 h (4.94 mg/ L and 8.50 mg/ kg, respectively). The lowest concentrations were quantified at 2 h after the end of infusion (2.46 mg/ L and 3.88 mg/ kg, respectively). The prostatic tissue concentrations of
moxifloxacin were approximately twice as high as in corresponding serum. At the end of infusion the tissue and serum concentrations seemed to be already equilibrated, as their ratios did not differ significantly during the time of investigation. After an
intravenous infusion of 400 mg the serum and prostatic tissue concentrations of
moxifloxacin were well above the MIC values of most important prostatic pathogens. The high tissue/ serum ratio and the extended antibacterial spectrum suggests active concentration in the prostate which may translate into increased efficacy compared to group 2 and 3
fluoroquinolones in the treatment of
chronic bacterial prostatitis.