In article <Pine.3.89.9410252210.A4785-0100000 at isnet.is.wfu.edu>,
bmorrell at ISNET.IS.WFU.EDU ("Robert Morrell Jr.") writes:
<Imipenem has been successfully used to treat bacterial prostatitis, so
obviously it gets in there for some people, so you can hardly call it a
"wild" assumption. I would characterize your challenge as desperate.>
I asked for data that shows that imipenem penetrates the prostatic fluid.
I want direct measurements of imipenem in the prostatic fluid. I would
also like to see a study that concludes that imipenem is effective against
prostatitis. You have not provided that data.
<Actually this would be remarkably easy to test, with a simple serial
micro tube dilution of the fluid (filtered) in mueller hinton broth to
check for inhibition of a stock organism with a known MIC to imipenem.>
Do it.
<Your statement does not contradict mine. You found the organism (in the
blood), and cultured it, and treated it. Now because you cannot prove your
hypothesis that its source was the prostate, you are talking about PCR
and micromanipulation.>
Not unreasonable to talk about PCR or other technologies. Prostatitis
remains a disease of unknown etiology in 90% of the cases. The other 10%
are thought to be bacterial. Since often there is no difference in
symptoms, wbc's per high powered field in these two groups, it would make
sense to test the hypothesis that all prostatitis is bacterial with a
method more sensitive than culture, or with some method that can
definitively prove or disprove the hypothesis.
<=NOT E CLOACAE=><snip>< That the prostate somehow stuns an enteric
rendering it unculturable but remaining pathogenic (laughable to anyone
who works with enterics, and clearly disproven by the many enterics
recovered from the prostate in bacterial cases)>
This has to be proved not guessed at. At indicated before Nickel found
that E. Coli seen on Electron Microscopy and found in prostatic biopsy
took 3 to 5 days to turn positive on culture. Since M & S protocols use
24 hours it was missed. Clearly the topic is not laughable to Nickel.
<Use any of the antibiotics used to successfully treat bacterial
prostatitis that have cross coverage. There are several, and as I said
this has been done before, and it did not work, which is why the CNS are
not considered to be the pathogen and (are you really listening?)>
Whether CNS is a pathogen is hotly debated in Urology. Some studies
support it and some do not. You claim that there are several "antibiotics
used to successfully treat bacterial prostatitis that have cross
coverage." Please name several that penetrate the prostate and have been
measured there, that kill both CNS and enterics, and that have double
blind studies proving their effectiveness.
<snip, as up above<>2 That M&S collection technique has low yeild in
organisms (possible, but unrelated to the rest of your hypotheses, which
rely on organism recovered or suspected in M&S specimens)>
You seem to be inventing hypothesis for me. The first part of the
sentence is my hypothesis.
<3 That antibiotics do not penetrate the prostate, which frees you to
believe apparently just about anything about any organism recovered or
not recovered. This hypothesis again fails in light of treatment success
in bacterial cases using the same or similar drugs....>
That antibiotics do not penetrate the hypothesis is not a hypothesis. The
difficulties of achieving MIC's in the prostatic fluid has been documented
over and over again. Antibiotic penetration has been such a problem that
the Quinolones have received a great deal of attention as the only group
to penetrate the prostate well.. What treatment successes are you talking
about? Most treatment successes in prostatitis occur in the acute form of
the disease when the endothelial barrier is thought to be non-existent and
thus the ability of the antibiotic to penetrate the prostate is moot.
Penetration across the membrane becomes a problem in Chronic Prostatitis.
