Hyperbaric Oxygen Therapy for Bacterial Infections

Current Evidence on HBOT

Hyperbaric oxygen therapy (HBOT) involves breathing 100% oxygen at pressurized atmospheres, which increases oxygen partial pressure in tissues, and has theoretical benefits including improved leukocyte function, inhibition of anaerobic bacterial growth, inhibition of toxin production, and enhancement of antibiotic activity, as recommended by the European Association of Urology guidelines 1, 2
Current guidelines conditionally recommend HBOT for specific conditions such as neuro-ischemic or ischemic diabetic foot ulcers where standard care has failed, with a strength of evidence rated as moderate, according to the Diabetes/Metabolism Research and Reviews 3, 1
HBOT is also recommended for necrotizing soft tissue infections as an adjunctive therapy after prompt surgical debridement, with a high strength of evidence, as stated in the World Journal of Emergency Surgery 4, 2

The diagnosis of chronic bacterial prostatitis requires the Meares and Stamey 2- or 4-glass test, as recommended by the European Association of Urology guidelines, with a high strength of evidence 5
When using amoxicillin for E. faecalis prostatitis, no evidence supports adding HBOT to amoxicillin therapy for this specific condition, according to the World Journal of Emergency Surgery, with a low strength of evidence 4

There are no clinical studies or guidelines supporting HBOT use specifically for chronic bacterial prostatitis, as stated in the Diabetes/Metabolism Research and Reviews and European Urology, with a low strength of evidence 3, 5, 1
HBOT has significant practical limitations, including high cost and limited availability, requiring specialized equipment and facilities, and potential side effects, as reported in the Diabetes/Metabolism Research and Reviews, with a moderate strength of evidence 1, 6