Organism-specific therapeutic regimens for prostatitis are provided below, including those for Escherichia coli, Pseudomonas, Enterococcus, Neisseria gonorrhoeae, and Chlamydia trachomatis.[1, 2]
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)
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
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]
See the list below:
Avoid prostatic massage in acute prostatitis to avoid seeding of the blood and subsequent bacteremia