Prostatitis Organism-Specific Therapy 

Updated: Apr 12, 2019
Author: Tarlan Hedayati, MD; Chief Editor: Thomas E Herchline, MD 

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]

Special considerations

See the list below:

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