How is acute bacterial prostatitis treated?

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

The primary management of prostatitis is medical therapy. In certain circumstances, however, surgical intervention may be required.

Acute bacterial prostatitis

The intensely inflamed prostate allows antimicrobials to easily pass from the plasma. Hospitalized patients with acute bacterial prostatitis can receive various antimicrobials; parenteral ampicillin and gentamicin are often used. In most cases, the fever resolves in 2 days.

Once improved, appropriate oral agents include TMP-SMZ or a fluoroquinolone (preferred). Therapy should be continued for a minimum of 4 weeks to prevent chronic bacterial prostatitis from developing. Analgesics and stool softeners may be helpful.

If the patient with acute prostatitis has significant urinary obstruction, a Foley catheter can be gently inserted. If this is too uncomfortable, a suprapubic cystotomy may be required. The catheter can usually be removed 1-2 days later.


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