Published online Mar 24, 2014. doi: 10.5410/wjcu.v3.i1.38
Revised: December 8, 2013
Accepted: February 16, 2014
Published online: March 24, 2014
Chlamydia trachomatis (Ct) infections are the most prevalent sexually transmitted bacterial infections worldwide, causing considerable morbidity and socio-economic problems. Moreover, Ct infections are asymptomatic in approximately 50% of infected men and 70% of infected women, with the risk for reproductive tract sequelae both in women and men. Recent studies have improved the comprehension of this infection and its natural history, also highlighting its role in decreasing male fertility. Severe complications can be avoided only by a proper early diagnosis and appropriate treatment. We reviewed the literature relating to the new findings in the treatment of Ct infection in sexually active young men. Articles from 1960-2012 were identified through a Medline search using the keywords “Chlamydia trachomatis” combined with “urethritis”, “epididymitis”, “prostatitis”, “treatment” or “management”. Currently, several studies have been published about the role of new antibiotic schedules and new associated compounds in order to improve the efficacy in terms of microbiological results and patient quality of life. In particular, several studies stress the fact that Chlamydia is only metabolically active in the host cell and therefore only targeted intracellularly by antibiotics. Even although the standard therapy includes intracellularly-accumulated antibiotics such as tetracyclines or macrolides, recent evidence highlights the role of quinolones. In particular, recent studies highlight the role of prulifloxacin in the treatment of chronic prostatitis for improving the patient’s quality of life and decreasing the IL-8 level. However, future studies should focus on delineating the natural history of recurrent infections, paying particular attention to treatment failures.
Core tip:Chlamydia trachomatis (Ct) infection is the most prevalent sexually transmitted bacterial infection worldwide with a significant impact on young male fertility. Ct represents a challenge for the urologist, both for diagnosis and treatment. An accurate comprehension of the pathology, diagnosis and treatment of this entity is essential for the urologist in order to prevent persistent consequences and improve the patient’s quality of life. We summarize the most current developments in the treatment of young men affected by chronic prostatitis due to Ct infection.