From the FDA Drug Label
Levofloxacin tablets are indicated for the treatment of chronic bacterial prostatitis due to Escherichia coli, Enterococcus faecalis, or methicillin-susceptible Staphylococcus epidermidis [see Clinical Studies (14.6)]. Adult patients with a clinical diagnosis of prostatitis and microbiological culture results from urine sample collected after prostatic massage (VB3) or expressed prostatic secretion (EPS) specimens obtained via the Meares-Stamey procedure were enrolled in a multicenter, randomized, double-blind study comparing oral levofloxacin 500 mg, once daily for a total of 28 days to oral ciprofloxacin 500 mg, twice daily for a total of 28 days.
The treatment options for prostatitis include levofloxacin.
- The microbiologic eradication rate by patient infection at 5 to 18 days after completion of therapy was 75% in the levofloxacin group and 76.8% in the ciprofloxacin group.
- Clinical success (cure + improvement with no need for further antibiotic therapy) rates in microbiologically evaluable population 5 to 18 days after completion of therapy were 75% for levofloxacin-treated patients and 72.8% for ciprofloxacin-treated patients 1.
- Levofloxacin is indicated for the treatment of chronic bacterial prostatitis due to Escherichia coli, Enterococcus faecalis, or methicillin-susceptible Staphylococcus epidermidis 1.
From the Research
Treatment for prostatitis should be based on the specific type, with fluoroquinolones like ciprofloxacin or levofloxacin being first-line treatments for bacterial prostatitis, and a multimodal approach including alpha-blockers, anti-inflammatory medications, and supportive measures for chronic nonbacterial prostatitis/chronic pelvic pain syndrome. The treatment options for prostatitis depend on the specific type, but typically include antibiotics, anti-inflammatory medications, and supportive measures.
- For bacterial prostatitis, fluoroquinolones like ciprofloxacin (500mg twice daily) or levofloxacin (500mg once daily) are first-line treatments, usually prescribed for 2-4 weeks for acute cases and 4-6 weeks for chronic bacterial prostatitis, as shown in a study published in 2019 2.
- Trimethoprim-sulfamethoxazole (160/800mg twice daily) is an alternative option.
- For chronic nonbacterial prostatitis/chronic pelvic pain syndrome, treatment focuses on symptom management with alpha-blockers like tamsulosin (0.4mg daily) to relax prostate muscles, nonsteroidal anti-inflammatory drugs like ibuprofen (400-600mg three times daily) for pain and inflammation, and muscle relaxants such as diazepam (5mg daily) for pelvic floor tension, as discussed in a study published in 2011 3. Supportive measures include warm sitz baths, increased fluid intake, avoiding irritants like caffeine and alcohol, and pelvic floor physical therapy.
- Some patients benefit from prostate massage to drain secretions or stress management techniques.
- Treatment often requires a multimodal approach as prostatitis can be challenging to treat completely, especially chronic forms that may need longer-term management strategies, as noted in a study published in 2016 4. The most recent and highest quality study, published in 2019 2, provides the most up-to-date guidance on the treatment of prostatitis, and its recommendations should be prioritized in clinical practice.