Pharmacokinetics of clarithromycin in the prostate: Implications for the treatment of chronic abacterial prostatitis

Purpose: We studied the pharmacokinetics of orally administered clarithromycin in prostatic tissue to define its role in the treatment of chronic abacterial prostatitis caused by intracellular pathogens. Materials and Methods: A total of 45 men receiving 3 oral doses of 750 mg. clarithromycin at 12-hour intervals underwent suprapubic prostatectomy for benign prostate hyperplasia 4, 5, 6 and 7 hours after the last drug dose in 13, 12, 10 and 10 patients, respectively. Concentrations were determined in the prostate tissue and in plasma by an agar diffusion assay. Results: A mean peak level of clarithromycin of 3.22 and 3.08 mug./gm. of tissue was achieved 4 hours after the third drug dose at the center and periphery of the adenoma, respectively. Tissue levels remained statistically superior to plasma levels at all intervals. Conclusions: The oral administration of clarithromycin achieved a prostate level much higher than the minimal inhibitory concentration of clarithromycin for the intracellular pathogens of chronic prostatitis. Thus, clarithromycin may be considered for treating chronic abacterial prostatitis.