What opportunistic infections affect the prostate?

From the Guidelines

Opportunistic prostate infections are typically caused by bacteria and fungi, and require prompt treatment to prevent complications.

Common Opportunistic Infections

• Bacterial prostatitis: caused by Enterobacterales, such as Escherichia coli, and other enteric bacteria, Pseudomonas spp, Staphylococcus aureus, Enterococcus, and Group B streptococci 1
• Fungal prostatitis: caused by fungi such as Coccidioides immitis, Blastomyces dermatitidis, and Histoplasma capsulatum 1
• Mycobacterial prostatitis: caused by Mycobacterium tuberculosis 1

Treatment

For acute bacterial prostatitis, a fluoroquinolone such as ciprofloxacin 500 mg twice daily or levofloxacin 500 mg daily for 4-6 weeks is recommended 1. Alternatively, trimethoprim-sulfamethoxazole 160/800 mg twice daily for 4-6 weeks can be used. For chronic bacterial prostatitis, a longer treatment duration of 12 weeks may be necessary. In cases of severe infection, hospitalization and intravenous antibiotics such as ceftriaxone 1-2 grams daily may be required. For fungal prostatitis, treatment with antifungal agents such as fluconazole or amphotericin B may be necessary 1. It is essential to consult a healthcare professional for proper diagnosis and treatment, as the choice of antibiotic and duration of treatment may vary depending on the individual case and local resistance patterns.

From the FDA Drug Label

Chronic Bacterial Prostatitis Levofloxacin tablets are indicated for the treatment of chronic bacterial prostatitis due to Escherichia coli, Enterococcus faecalis, or methicillin-susceptible Staphylococcus epidermidis

The opportunistic infections that affect the prostate are Chronic Bacterial Prostatitis due to:

• Escherichia coli
• Enterococcus faecalis
• Methicillin-susceptible Staphylococcus epidermidis 2

From the Research

Opportunistic Infections Affecting the Prostate

The prostate can be affected by various opportunistic infections, including:

• Acute bacterial prostatitis, which can be caused by uropathogens such as Escherichia coli, Enterobacteriae species, and Staphylococcus saprophyticus 3
• Chronic bacterial prostatitis, which is characterized by recurrent episodes of documented urinary tract infections with the same uropathogen 4
• Nonbacterial prostatitis and chronic pelvic pain syndrome, which are more common than bacterial prostatitis, but their etiologies are largely unknown 5

Bacterial Etiologies

The bacterial etiologies of prostatitis include:

• Gram-negative bacilli, which cause most urinary tract and prostate infections 5
• Pseudomonas aeruginosa, which requires consideration in the treatment of serious urinary tract infections 6
• Staphylococcus saprophyticus, which is a relatively unique cause of acute bacterial prostatitis 3

Treatment Considerations

The treatment of prostatitis requires consideration of the following factors:

• The use of effective antimicrobial therapy, which is the foundation of management of serious urinary tract infections and bacterial prostatitis 6
• The selection of the optimal antimicrobial agent, which must take into account patient-specific factors, infection characteristics, and local resistance patterns 6
• The use of fluoroquinolones, which are among the alternatives for empirical antibiotic treatment of serious urinary tract infections and acute bacterial prostatitis 6, 7
• The duration of antibiotic therapy, which typically ranges from 1 to 2 weeks for cystitis, 4 weeks for acute bacterial prostatitis, and 6 to 12 weeks for chronic bacterial prostatitis 5