From the Guidelines
The treatment for prostatitis typically involves addressing the underlying cause and providing antimicrobial therapy, with a recommended treatment duration of 7 to 14 days, depending on the severity of the illness and local resistance patterns 1. When managing prostatitis, it is essential to consider the clinical presentation, diagnostic approach, and treatment for acute and chronic prostatitis. According to the European Association of Urology guidelines, appropriate management of the urological abnormality or the underlying complicating factor is mandatory, and optimal antimicrobial therapy depends on the severity of the illness at presentation, as well as local resistance patterns and specific host factors 1. Some key points to consider in the treatment of prostatitis include:
- The microbial spectrum is greater than for uncomplicated UTIs, and antimicrobial resistance is more likely 1
- E. coli, Proteus spp., Klebsiella spp., Pseudomonas spp., Serratia spp., and Enterococcus spp. are the most common species found in cultures 1
- A urine culture and susceptibility testing should be performed, and initial empiric therapy should be tailored and followed by (oral) administration of an appropriate antimicrobial agent for the uropathogen isolated 1
- Treatment for 7 d to 14 d (14 d for men when prostatitis cannot be excluded) is generally recommended, but the duration should be closely related to the treatment of the underlying abnormality 1 However, it is worth noting that the optimal durations of treatment for acute bacterial prostatitis (ABP) or chronic bacterial prostatitis (CBP) are unknown and have not been established by high-quality studies 1. In clinical practice, the treatment of prostatitis should be individualized, taking into account the severity of the illness, local resistance patterns, and specific host factors, with the goal of reducing morbidity, mortality, and improving quality of life 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Treatment for Prostatitis
The treatment for prostatitis varies depending on the type and severity of the condition.
- For acute bacterial prostatitis, treatment typically involves oral antibiotics and supportive measures, with hospitalization and broad-spectrum intravenous antibiotics considered in severe cases 2.
- Chronic bacterial prostatitis and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) may be treated with antimicrobials, alpha blockers, and anti-inflammatory agents, although the effectiveness of these agents has not been supported in clinical trials 3.
- The mainstay of therapy for prostatitis is an antimicrobial regimen, with the goal of reducing pelvic pain in CP/CPPS 4.
- A consensus guideline recommends managing patients with CBP and CP/CPPS according to their individual symptom pattern, with options for first-line treatment including antibiotics, α-adrenergic antagonists, and simple analgesics 5.
- For acute prostatitis, oral or intravenous antibiotics are usually effective for curing the infection, although immunosuppressed patients may require special consideration and additional therapies 6.
Treatment Options
Some specific treatment options for prostatitis include:
- Ceftriaxone and doxycycline, ciprofloxacin, and piperacillin/tazobactam for acute bacterial prostatitis 2
- Quinolones, although repeated use should be avoided if there is no obvious symptomatic benefit from infection control or cultures do not support an infectious cause 5
- α-adrenergic antagonists for voiding lower urinary tract symptoms (LUTS) 5
- Simple analgesics for pain management 5
- Nonpharmacologic modalities, although limited support is available 3