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Prostatitis Organism-Specific Therapy 

  • Author: Tarlan Hedayati, MD; Chief Editor: Thomas E Herchline, MD  more...
 
Updated: Dec 17, 2014
 
 

Specific Organisms and Therapeutic Regimens

Organism-specific therapeutic regimens for prostatitis are provided below, including those for Escherichia coli, Pseudomonas, Enterococcus, Neisseria gonorrhoeae, and Chlamydia trachomatis.

Acute bacterial prostatitis

E coli, other Enterobacteriaceae[1, 2] :

Pseudomonas:

  • Ciprofloxacin 500 mg PO BID for 28d

Enterococcus:

N gonorrhoeae:

Chronic bacterial prostatitis

E coli, other Enterobacteriaceae[3, 2, 4] :

  • Ciprofloxacin 500 mg PO BID for 28d or
  • Ofloxacin 200 mg PO BID for 28d or
  • TMP/SMX 1 DS tablet BID for 28d

Pseudomonas:

  • Ciprofloxacin 500 mg PO BID for 28d

Enterococcus[5] :

  • Ampicillin 500 mg PO TID or 875 mg PO BID for 28d

C trachomatis:

  • Doxycycline 100 mg PO BID for 7-14d or
  • Ofloxacin 400 mg PO BID for 7-14d

Adjunctive therapy

See the list below:

  • For acute bacterial prostatitis, provide supportive measures, such as antipyretics, analgesics, hydration, and stool softeners, as needed
  • Urinary retention may warrant hospitalization, as it can complicate infection; it is safer to use a suprapubic catheter instead of urethral catheterization in severe obstruction (place in consultation with urologist)[6, 7]

Special considerations

See the list below:

  • Avoid prostatic massage in acute prostatitis to avoid seeding of the blood and subsequent bacteremia
 
Contributor Information and Disclosures
Author

Tarlan Hedayati, MD Assistant Professor of Emergency Medicine, Rush Medical College, John H Stroger Hospital of Cook County

Tarlan Hedayati, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Coauthor(s)

Christine R Stehman, MD Clinical Assistant Professor of Emergency Medicine, Indiana University School of Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Jasmeet Anand, PharmD, RPh Adjunct Instructor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Chief Editor

Thomas E Herchline, MD Professor of Medicine, Wright State University, Boonshoft School of Medicine; Medical Director, Public Health, Dayton and Montgomery County, Ohio

Thomas E Herchline, MD is a member of the following medical societies: Alpha Omega Alpha, Infectious Diseases Society of Ohio, Infectious Diseases Society of America

Disclosure: Nothing to disclose.

References
  1. Rhee JJ, Piesman M, Costabile RA. Acute bacterial prostatitis and prostatic abscess. Medscape Reference. Available at http://emedicine.medscape.com/article/439968-overview. Accessed: Dec 21, 2009.

  2. Wagenlehner FM, Naber KG. Prostatitis: the role of antibiotic treatment. World J Urol. 2003 Jun. 21(2):105-8. [Medline].

  3. Murphy AB, Macejko A, Taylor A, et al. Chronic prostatitis: management strategies. Drugs. 2009. 69(1):71-84. [Medline].

  4. Choe HS, Lee SJ, Han CH, Shim BS, Cho YH. Clinical efficacy of roxithromycin in men with chronic prostatitis/chronic pelvic pain syndrome in comparison with ciprofloxacin and aceclofenac: a prospective, randomized, multicenter pilot trial. J Infect Chemother. 2014 Jan. 20(1):20-5. [Medline].

  5. Seo Y, Lee G. Antimicrobial Resistance Pattern in Enterococcus faecalis Strains Isolated From Expressed Prostatic Secretions of Patients With Chronic Bacterial Prostatitis. Korean J Urol. 2013 Jul. 54(7):477-81. [Medline]. [Full Text].

  6. Le BV, Schaeffer AJ. Genitourinary pain syndromes, prostatitis, and lower urinary tract symptoms. Urol Clin North Am. 2009 Nov. 36(4):527-36, vii. [Medline].

  7. Luzzi G. The prostatitis syndromes. Int J STD AIDS. 1996 Nov-Dec. 7(7):471-8. [Medline].

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