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Acute and chronic prostatitis discussion. Arnon Krongrad, MD, moderator.

Synergistic effects of natural compounds with antibiotics in CBP

To have the best chance of beating this type of infection then you're going to be clever. One of the reasons why infections like these may persist is because of biofilms which protect the bacteria from antibiotics and the immune system. Most compounds like the ones below such as: catechins, lycopene, quercetin, curcumin, garlic or allicin, and lactoferrin among others all seem to have an effect on bacteria by either being bacteriostatic or bactercidal and at lower concentrations which are more likely to be achieved in humans could be able to block quorum sensing which would enable the antibiotics like quinolones, tetracycline or trimethoprim to kill the bacteria.  If you look on pubmed for these compounds you will find that most are synergistic with various antibiotics by more than just one mechanism. Sometimes they are able to reverse resistance also. I would recommend reading these:

Garlic blocks quorum sensing and promotes rapid clearing of pulmonary Pseudomonas aeruginosa infections http://www.ncbi.nlm.nih.gov/pubmed/16339933

So the idea basically is that you would  use antibiotics in combination with these natural compounds to increase the chances of a cure. In both animals and humans there seems to be a synergistic effect between antibiotics and natural compounds in treating prostatitis.
serenoa repens associated with Urtica dioica (ProstaMEV) and curcumin and quercitin (FlogMEV) extracts are able to improve the efficacy of prulifloxacin in bacterial prostatitis patients: results from a prospective randomised study.
http://www.ncbi.nlm.nih.gov/pubmed/19181486
"Group A comprised 106 patients and Group B comprised 37 patients. One month after treatment, 89.6% of patients who had received prulifloxacin associated with ProstaMEV and FlogMEV did not report any symptoms related to CBP, whilst only 27% of patients who received antibiotic therapy alone were recurrence-free (P < 0.0001)"
(Mateo: this is similar to what is seen in rat models of cbp)

Synergistic effect between catechin and ciprofloxacin on chronic bacterial prostatitis rat model
http://www.ncbi.nlm.nih.gov/pubmed/15948727

Synergistic effect between lycopene and ciprofloxacin on a chronic bacterial prostatitis rat model.
http://www.ncbi.nlm.nih.gov/pubmed/17920247

Anti-inflammatory and antimicrobial effects of garlic and synergistic effect between garlic and ciprofloxacin in a chronic bacterial prostatitis rat model.
http://www.ncbi.nlm.nih.gov/pubmed/19375896

Combining Biofilm-Controlling Compounds and Antibiotics as a Promising New Way to Control Biofilm Infections
http://www.mdpi.com/1424-8247/3/5/1374/htm#B8
Epigallocatechin-Gallate Enhances the Activity of Tetracycline in Staphylococci by Inhibiting Its Efflux from Bacterial Cells
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC415601/

Anyway I am just sharing my idea.  I am still doing well after trying allicin max in combination with trimethoprim, and then continuing on with allicinmax. I think that if one wants to achieve the best possible chance of a cure they would need to combine treatments and complete a full 1-3 month course of antibiotics with these compounds.

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Replies to This Discussion

In regards to http://www.ncbi.nlm.nih.gov/pubmed/19181486

What kind of randomization
results in Group A having 106 patients and Group B having 37 patients?

This may have been randomized, even if a suspicious sort of randomization, but this study was not blinded: Group A knew it was being treated extra well because it knew it was getting ProstaMEV and FlogMEV. Group A would not have known this if a placebo had been in use, but it was not. What is the effect on symptoms of the knowledge that you are being treated?


The followup of one month seems short for chronic prostatitis. What is the long-term durability of responses?

One month after treatment, 89.6% of patients who had received prulifloxacin associated with ProstaMEV and FlogMEV did not report any symptoms related to CBP, whilst only 27% of patients who received antibiotic therapy alone were recurrence-free

(P < 0.0001)

 

"Six months after treatment, no patients in Group A had recurrence of disease whilst two patients in Group B did."

 

I think that you might have missed it on the abstract where it said there was a followup of 6 months. Shame about the lack of placebo with the antibiotic in the other group, but given the significance of the results it might be worth those with prostatitis trying combination therapies using antibiotics and natural compounds. Although some caution should be taken as some compounds in foods are able to alter the pharmokinetics of certain drugs.

 

Yes, we have symptoms data for 1 month. And recurrence data for 6 months, at which point just about everyone -- with or without ProstaMEV and FlogMEV -- had no recurrence.

 

Lack of placebo is less about shame than about potentially biasing patient perception and thus self-reporting of symptoms. Had the control group gotten placebo, for all we know it would have fared better than the treatment group. Put another way, it may be that the ProstaMEV and FlogMEV are actually exerting a placebo effect -- causing the patients who take it to believe they are being treated and thus to feel better -- without actually being therapeutic. Without a control placebo blindly administered, this is a possibility that we cannot exclude.

 

This video provides a funny but legitimate exploration of the placebo effect.

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