Observations on Activity of Trimethoprim-Sulfamethoxazole in the Prostate

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Abstract
Trimethoprim (TMP) is highly effective against most gram-positive and gram-negative bacteria. The chemical properties of this drug meet all theoretical requirements for diffusion and concentration in prostatic fluid relative to the level of plasma. Experimental work in dogs by three groups of investigators has confirmed a ratio of TMP in prostatic fluid to that in plasma of at least 3:1. Synergistic antibacterial activity results when TMP is combined with a sulfonamide. Thirteen male volunteers who had reproducible laboratory evidence of chronic bacterial prostatitis were given two tablets of trimethoprim-sulfamethoxazole (TMP-SMZ) twice daily for 14 days. Two patients were cured, nine patients were significantly improved, and two patients were unchanged by therapy. These results suggest that TMP-SMZ may assume an important role in the management of patients who have chronic bacterial prostatitis.

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