What is the role of quinolones in the treatment of prostatitis?

Updated: Aug 27, 2019
  • Author: John L Brusch, MD, FACP; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Quinolones can be divided into first, second, third, and fourth generations. First-generation drugs (nalidixic acid) are not effective for prostatic infections. Third- and fourth-generation fluoroquinolones provide increased streptococcal and anaerobic coverage, which is not needed to treat prostatic infections.

The second-generation quinolones widely used to treat prostatic infection include ciprofloxacin, ofloxacin, norfloxacin, and levofloxacin. These drugs all are bactericidal against gram-negative bacilli; however, because of increased resistance, they are no longer recommended by the US Centers for Disease Control and Prevention (CDC) for N gonorrhoeae infections. [17]

Levofloxacin is most effective against susceptible strains of Enterococcus faecalis and has the advantage of once-daily dosing. Although all of the second-generation drugs are used to treat prostatitis, only ofloxacin has been approved by the US Food and Drug Administration (FDA) for this indication.


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