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]}:

Ciprofloxacin 500 mg PO BID for 28d or
Ofloxacin 200 mg PO BID for 28d or
Trimethoprim-sulfamethoxazole (TMP/SMX) 1 DS tablet BID for 28d

Pseudomonas:

Ciprofloxacin 500 mg PO BID for 28d

Enterococcus:

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

N gonorrhoeae:

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:

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)^{[9, 10]}