prostatitis culture case

BCapstone bcapstone at aol.com
Thu Oct 27 11:44:03 EST 1994


In article <Pine.3.89.9410262139.A25191-0100000 at isnet.is.wfu.edu>,
bmorrell at ISNET.IS.WFU.EDU ("Robert Morrell Jr.") writes:

>> 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. 
>
>Need I remind you that =you= are the one questioning the penetration of 
>imipenem. =I= am not going to waste my time on an experiment whose 
>outcome is not in doubt.>

I don't thing that any experiment is a waste of time if designed properly.
 If you do not have "time to waste" perhaps you could go to another
thread, and not monopolize mine, where I am seeking advice on an
experiment that I am going to do.

<You wanted sources: For the penetration of imepenim into prostate tissue:
Current Theraputic Research 1989, vlo 46 pg 614-618
for successful therapy of bacterial prostatitis using imipenem: three
Journ of Antimicrobial therapy 1986 Dec. 175-179
Japanese Journ of Antibiotics 1986 Apr. 39(4) 996-1006
Journ of Japanese Ass. for Infect. Diseases 67(2) 154-162 1993 feb>

The first reference was available to me.  It measures the level of
Imipenem from a study of TURPS.  I called Merc.  The study does not
address the problem of using a slurry of tissue, prostatic fluid, and
blood to attempt to measure penetration of antibiotic into prostatic fluid
alone.  Apparently does not answer if the antibiotic is in the right
compartment or not.  They are unaware of any studies that document a
clinical cure and a culture cure in a case of Enterobacter prostatitis. 
They will do a literature search and send it to me.  As to your way of
studying the issure by using fluid and measuring inhibition, I have as yet
not found it to have been done.

<Now this raises a point that has been bothering me and others concerning
this thread.>

What others are you talking about?

<You claim to be a doctor that knows a lot about prostatitis,
yet you challenged me on the well known and readily available info of
imipenem's effectiveness in prostatitis (it took me all of two minutes to
find those three references)>

As noted above.

<Exactly what does your knowledge of prostatitis consist of, and how deep
has your research gone, if you are challenging something so easily
obtainable?>

I am not a researcher.  I am asking questions.  I do not think the
information is so easily obtainable, because with scrutiny one finds many
flaws or technical problems in prostatitis research.  This is why the
etiology of 90% of the cases remains unknown.  See NIH abstract for 90%
number.

<Furthermore, you claim to be a doctor in charge of a patient with
prostatitis and sepsis treated with imipenem. If you or the consult team
were unaware of imipenem's activity in the prostate, and, as you have
said, you believed the source of infection was the prostate, why did you 
prescribe it? Exactly what are the standards of care like in Chicago?>

What is your cure rate with Chronic Bacterial Prostatitis? 

<I and several others have responded to your questions on and off the 
list, sending you reference meaterials>

I believe that this is the first time you have ever sent I reference.

< . . . that addressed many of the 
questions you continue to pose even after they have been 
answered repeatedly. Several of us on this list have noted your 
persistantly anti-logical, seemingly willful ignorance on the subjects of:

microbiology, antibiotics, scientific theory and logic, and ultimately, 
prostatitis.>

I have not noticed any definitive "anwers" from your posts.

<The question has arisen, are you who you claim to be: Dr. Bradley
Hennenfent of Chicago? Or are you one of the following:
 1. A lawyer doing research (unlikely, because a lawyer would know better 
    than sign a false name on s-mail.)
 2. A patient investigating his own case.
 3. A novelist gathering material. (This was AOL's idea)
 4. An incredibly stubborn, pig-headed and ignorant physician.
My vote is on 4, but I am open to other theories.>

I am Bradley R. Hennenfent, MD.  I do not have an automatic name insertion
place in my software as yet.  I am pig-headed and will continue to be
until my patient is cured, and until the etiology of all cases of
prostatitis has been determined.





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