The 5-alpha reductase inhibitor finasteride is commonly prescribed as a treatment for benign prostate hyperplasia. Does it have a role in the treatment of prostatitis?

Using a rat experimental model, researchers in Korea have tested if pretreatment with finasteride, ciprofloxacin, or finasteride plus ciprofloxacin could have an effect on the prostates of rats infected with Escherichia coli:

• Relative to control, the finasteride group showed less infection and inflammatory infiltration.
• The addition of ciprofloxacin antibiotic further enhanced the preventive effect of the finasteride.

As the authors note, the mechanism of action of finasteride is not known. We do know that finasteride can cause atrophy of the prostatic epithelium (lining), so presumably any preventive effect is somehow mediated by epithelial cell death. In any event, the effect begs the question of whether or not men would take finasteride — which carries some risk  and inconvenience — for the prevention of bacterial prostatitis; this seems generally unlikely.

The data suggest that finasteride does not have much of a role in the treatment of chronic pelvic pain syndrome. The new observations do ask if finasterideis a useful treatment and/or adjunct to antibiotic treatment of bacterial prostatitis.