MedWire News: Antibiotics are unnecessarily prescribed for most men with chronic pelvic pain syndrome, US researchers report.

They found that antibiotics were prescribed for 69% of men with chronic pelvic pain syndrome without infectious prostatitis or urinary tract infection, despite routine use of such drugs not indicated in these patients.

Timothy Wilt (Minneapolis Veterans Affairs Medical Center, Minnesota, USA) and co-workers say their findings, which are based on the largest, fully integrated US healthcare system, are likely "valid and generalizable" to many other US systems.

The team calculated how frequently antibiotics were used to treat chronic pelvic pain syndrome using inpatient, outpatient, and pharmacy datasets from the Veterans Health Administration.

Men with a diagnosis of infectious or acute prostatitis or a urinary tract infection were excluded, while other prostatitis patients were defined as having chronic pelvic pain syndrome.

Fluoroquinolone antibiotic prescriptions were filled by 49% of men with, compared with 5.5% of men without, chronic pelvic pain syndrome.

After adjusting for age, race/ethnicity, and comorbid conditions, chronic pelvic pain patients were 7.9-times more likely to be prescribed antibiotics than men with no prostatitis diagnosis, the team reports in the American Journal of Medicine.

Increased use of other antibiotics was also observed.

The increased likelihood of fluoroquinolone prescriptions, after adjustment for confounding factors, was similar in men with chronic pelvic pain as for those with infectious acute prostatitis.

Wilt and team say this suggests that "coding issues do not explain the majority of the association, and instead antibiotics are not being restricted to those with confirmed bacterial infections."

They add: "A seven-fold higher rate of fluoroquinolone usage suggests that strategies to reduce unnecessary antibiotic use in men with prostatitis are warranted."

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