From the Guidelines
Prostatitis caused by E. coli should be treated with fluoroquinolones, such as ciprofloxacin or levofloxacin, for 4-6 weeks, as recommended by the European Association of Urology guidelines 1. The treatment approach for prostatitis caused by E. coli involves a comprehensive understanding of both prevention and treatment strategies.
- Prevention involves proper hygiene practices, staying hydrated, urinating after sexual intercourse, and completing the full course of antibiotics when prescribed.
- E. coli typically enters the prostate through the urethra, often ascending from the urinary tract, causing inflammation, swelling, and symptoms including painful urination, pelvic pain, fever, and urinary urgency.
- For acute cases, treatment may begin with IV antibiotics if symptoms are severe, and chronic bacterial prostatitis may require longer treatment courses and possibly prostate massage to help release trapped bacteria.
- Patients should seek medical attention promptly if experiencing symptoms, as untreated infections can lead to complications including abscess formation or systemic infection, and diagnosis relies on clinical presentation and laboratory tests, with the optimal durations of treatment for ABP or CBP still unknown and requiring additional prospective studies 1. Key considerations in managing prostatitis include:
- Using the classification proposed by the National Institute of Diabetes, Digestive, and Kidney Diseases to distinguish bacterial prostatitis from chronic pelvic pain syndrome 1.
- Recognizing that Enterobacterales, including E. coli, are the primary pathogens in acute bacterial prostatitis, and that chronic bacterial prostatitis encompasses a broader spectrum of species 1.
From the Research
Prostatitis from Ecoli Education
- Prostatitis is an infection of the prostate gland that can cause pelvic pain and urinary tract symptoms, such as dysuria, urinary frequency, and urinary retention 2.
- The causative organisms of prostatitis are usually similar to those that cause other common genitourinary infections, and include Escherichia coli (Ecoli) and Enterococcus spp. 3.
- Ecoli is a common cause of acute bacterial prostatitis, which can be diagnosed based on history, physical examination, urine culture, and urine specimen testing pre- and post-prostatic massage 2, 4.
- Treatment of acute bacterial prostatitis typically involves oral antibiotics, such as ceftriaxone and doxycycline, ciprofloxacin, and piperacillin/tazobactam 2.
- In cases of chronic bacterial prostatitis, long-term therapy with antibacterial agents, such as fluoroquinolones, macrolides, tetracyclines, and trimethoprim, may be necessary 5.
- The risk of nosocomial bacterial prostatitis can be reduced by using antibiotics, such as ciprofloxacin, before transrectal prostate biopsy 2.
- Patient populations who are at especially high risk of acute prostatitis include those with diabetes, cirrhosis, and suppressed immune systems 3.
- Immunosuppressed patients require special consideration, as bacterial prostatitis in these patients can be caused by atypical infecting organisms and might, therefore, require additional therapies 3.