Journal of Chemotherapy Vol. 18 - n. 5 (485-489) - 2006 © E.S.I.F.T. srl - Firenze ISSN 1120-009X INTRODUCTION The prostatitis syndrome is one of the most common infectious entities encountered in urologic practice. Classification of the prostatitis syndrome is based on the clinical presentation of the patient, the presence or absence of white blood cells in the expressed prostatic secretion (EPS), and the pres- ence or absence of bacteria in the EPS 1 . Depending upon the duration of symptoms, prostati- tis is described as either acute or, where symptoms are present for at least 3 months, chronic. The clas- Serum and Prostatic Tissue Concentrations of Moxifloxacin in Patients Undergoing Transurethral Resection of the Prostate F.M.E. WAGENLEHNER 1 - J.C. LUNZ 2 - F. KEES 3 - W. WIELAND 2 - K.G. NABER 1 1 Urologic Clinic, Hospital St. Elisabeth, Straubing, Germany. 2 Urologic Clinic, Hospital St. Josef, University of Regensburg, Germany. 3 Department of Pharmacology, University of Regensburg, Germany. Corresponding author: Florian M.E. Wagenlehner, Urologic Clinic, Hospital St. Elisabeth, St. Elisabeth Str. 23, D-94315 Straubing, Germany. Tel. +49 9421 710 6702; Fax. +49 9421 710 1717. E-mail address: Wagenlehner@AOL.com. Summary 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 concentra- tions 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 approximate- ly 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 dif- fer significantly during the time of investigation. After an intravenous infusion of 400 mg the serum and prostatic tissue concen- trations of moxifloxacin were well above the MIC values of most important prostat- ic 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. Key words: Chronic bacterial prostatitis, moxifloxacin, Pharmacokinetics, serum concentrations, prostatic tissue concentrations. REVIEW copy for private use only