Therapeutics · Anti-Infective and Anti-Inflammatory Agents
RRM Academy Synopsis
Infertile men given probiotics plus antibiotics cleared infection more
Infection cleared in about 8 out of 10 men who took probiotics with antibiotics. Men on antibiotics alone cleared it in 5 out of 10. This retrospective study followed 104 infertile Italian men with male accessory gland infection. Each man picked his own treatment.
Key Findings
- Complete eradication, with negative semen culture and negative analysis of prostatic secretion, occurred in 64 of 84 men (76.2%) who received probiotics with antibiotics.
- Among 20 men who received antibiotics alone, 10 (50%) had negative results (p < .05).
- Infections involved a single germ in 89% of men and several germs in 11%.
- Persistent infection after treatment occurred only with Enterococcus and Escherichia coli. With the Enterococcus species, 34 of 47 men (72.3%) cleared it with probiotics and 5 of 10 (50%) without.
- With E. coli, 13 of 20 men (65%) cleared infection with probiotics and 2 of 4 (50%) without. Neither subgroup difference was statistically significant.
Interpretation
This retrospective study had no randomization. Patient preference chose the group: 84 men took the probiotic combination and 20 took antibiotics alone. The men were aged 20 to 55, with primary infertility and Gram-negative bacteria in semen or prostatic secretions. The authors call the work preliminary. Clearance was higher with probiotics in the two subgroups where infection persisted, and neither gap reached statistical significance. The outcome was bacterial clearance. The authors write that symptoms and semen quality after treatment await prospective studies.
RRM Context
Restorative reproductive medicine evaluates both partners. A male genital tract infection can be a diagnosable cause, and semen cultures can find it. The introduction cites an estimate that up to 15% of male fertility disorders link to infections and inflammation. The reported outcome is bacterial clearance, so births after clearing infection remain unmeasured.
Abstract
Male accessory gland infection (MAGI) represents a frequent disease, commonly treated with antibiotics alone. However, in approximately 40% to 50% of patients, persistent infection is detected. Intestinal dysbiosis is involved in the pathogenesis of prostatitis. We aimed to evaluate the efficacy of antibiotic treatment in association with a specific probiotic supplementation. A total of 104 infertile patients, with microbiological analysis on semen and/or prostatic secretions positive for Gram-negative bacteria, have been enrolled. All patients received antibiotic treatment with fluoroquinolones. In total, 84 patients received a commercial association of Enterococcus faecium and Saccharomyces boulardii during antibiotic treatment, followed by treatment with Lactobacilli. After the treatment, a complete microbiological analysis was repeated. Polymicrobial infections have been observed in 11% of patients, while infections due to a single germ were reported in 89% of the patients. After the treatment was performed, a complete eradication with negative semen culture and microbiological analysis on prostatic secretion was observed in 64 of 84 patients (76.2%), while only 10 of 20 patients receiving antibiotics alone (50%; p < .05) reported negative microbiological analysis. Persistent infections have been observed only in patients with infections due to Enterococcus faecalis and Escherichia coli. This study represents the first approach demonstrating the efficacy of a specific probiotic treatment in reducing the rate of persistent infections in patients with MAGI.