Patients with chronic bacterial prostatitis often face a double challenge: they suffer not only from the symptoms of the disease but also from difficulties treating the infection. The prostate gland's lining is impermeable to many classes of antibiotics, so the treatment options for bacterial prostatitis are very limited. An additional challenge is the increasing prevalence of antibiotic-resistant bacteria, as well as the formation of bacterial biofilms, which significantly complicate antibiotic therapy for this disease. Thus, treating chronic recurrent prostatitis is challenging. Bacteriophages can now be considered as an alternative to antibiotics in the treatment of this pathology. A paper describing a clinical case of chronic bacterial prostatitis treated with bacteriophages was published in the journal Frontiers in Pharmacology.

A 33-year-old man diagnosed with bacterial prostatitis with typical symptoms, including daily fever up to 37.5°C, had pathogenic bacteria in his prostate fluid and semen samples: methicillin-resistant Staphylococcus aureus (MRSA), Staphylococcus haemolyticus , Enterococcus faecalis , Streptococcus mitis , and others. The patient received five courses of antibiotic therapy (oral and intravenous), but all were ineffective and failed to provide lasting symptom relief. As a result, he was prescribed symptomatic therapy—NSAIDs and painkillers—but the cause of the inflammation was not addressed. Finally, the man decided to try phage therapy and contacted the G. Eliava Phage Therapy Center in Tbilisi, Georgia.

Following thorough testing, phage preparations specific to the existing pathogens were selected. The patient underwent three courses of phage therapy, each lasting three months. The following medications were used: pyo-, intesti-, fersi-, ses-, enco-, and staphylococcal bacteriophages in various forms: oral (solution), rectal (suppositories), and urethral instillation (solution). The treatment regimen was modified based on the examination results. A detailed phage therapy regimen is available in the article https://www.frontiersin.org/articles/10.3389/fphar.2021.692614/full

By the fifth day of treatment, the patient's temperature had returned to normal and no longer rose above 37°C. Bacteriological analysis and imaging studies showed significant improvement during and after bacteriophage treatment. These improvements correlated with symptomatic relief.

* Johri AV, Johri P, Hoyle N, Pipia L, Nadareishvili L and Nizharadze D. Case Report: Chronic Bacterial Prostatitis Treated With Phage Therapy After Multiple Failed Antibiotic Treatments. Front. Pharmacol., 2021; 12:692614. doi: 10.3389/fphar.2021.692614