What are considerations in the use of antibiotic treatment for chronic bacterial prostatitis (CBP)?

Updated: Jan 15, 2019
  • Author: Samantha D Kraemer, MD; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

Although bacteria are cultured in only 5%-10% of prostatitis cases, bacteria may still be the cause of the chronic prostatitis in many patients with the syndrome. Studies using extensive research methods (eg, reverse transcriptase polymerase chain reaction assay) show evidence of bacterial infection in some patients despite negative urine cultures. Negative culture results occur for various reasons, including insufficient sample volume, initiation of antibiotics prior to obtaining an expressed prostatic secretion sample, and the presence of fastidious organisms.

In such cases, patients often have improvement in symptoms with antibiotic treatment. Thus, if clinical evidence strongly suggests chronic prostatitis in a patient with negative cultures, a 2-week trial of antibiotics is worthwhile. If the symptoms improve, prescribe a complete course of antibiotics.


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