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. [1, 2]
Acute bacterial prostatitis
E coli, other Enterobacteriaceae [3, 4, 5] :
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Ciprofloxacin 500 mg PO BID for 28d or
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Ofloxacin 200 mg PO BID for 28d or
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Trimethoprim-sulfamethoxazole (TMP/SMX) 1 DS tablet BID for 28d
Pseudomonas:
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Ciprofloxacin 500 mg PO BID for 28d
Enterococcus:
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Ampicillin 500 mg PO TID or 875 mg PO BID for 28d
N gonorrhoeae:
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Ceftriaxone 250 mg IV as a single dose plus (azithromycin 1 g PO as a single dose or doxycycline 100 mg PO BID for 7d)
Chronic bacterial prostatitis
E coli, other Enterobacteriaceae [6, 4, 7] :
-
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 [8] :
-
Ampicillin 500 mg PO TID or 875 mg PO BID for 28d
C trachomatis:
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Doxycycline 100 mg PO BID for 7-14d or
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Ofloxacin 400 mg PO BID for 7-14d
Adjunctive therapy
See the list below:
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For acute bacterial prostatitis, provide supportive measures, such as antipyretics, analgesics, hydration, and stool softeners, as needed
Special considerations
See the list below:
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Avoid prostatic massage in acute prostatitis to avoid seeding of the blood and subsequent bacteremia