Probiotics in the Management of Chronic Bacterial Prostatitis Patients: A Possible Link with Gut Microbiota Restoring and Symptoms Relief

Background: Several studies hypothesized a therapeutic role of probiotics in the management of chronic bacterial prostatitis (CBP) patients. Here, we assessed the effect of probiotics as an add-on treatment in patients with clinical recurrences of CBP, through gut microbiota modification analysis. Methods: This study has been planned as a randomized, double-blind, placebo-controlled, multicenter clinical trial examining the efficacy and safety of consumption of probiotics containing human Lactobacillus casei DG® or placebo following 1 month-treatment with ciprofloxacin. Twenty-four patients with CBP were recruited and treated for 3 months with placebo (n. 12) or with Lactobacillus Casei DG® (n. 12). During the enrollment and follow-ups, IPSS, NIH-CPSI and SF-36 were used. Urological examinations and microbiological tests were performed to analyze the symptomatology, recurrences frequency, and gut and seminal microbiota. Results: The treatment with Lactobacillus Casei DG® induced a significantly (p<0.01) faster recovery of symptoms (2 days vs. 8 days) than placebo and an increased time free from symptoms (86 days vs. 42 days) without the occurrence of adverse events. In the treatment group, the appearance of Lactobacilli after 30 days (T1) was higher in the probiotic group, and a significant reduction of Corynebacterium, Peptoniphilus, Pseudomonas, Veillonella, Staphylococcus and Streptococcus has been observed. Conclusion: These data suggest that in patients with CBP, the use of Lactobacillus casei DG after an antimicrobial treatment is safe and effective in improving the days free of symptoms and the quality of life.