Adult Outpatients: Urinary Tract Infections: Prostatitis

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Doses provided in this table are for patients with normal renal and hepatic function. Click on drug link to go to dosing guidelines.  Some antimicrobials are restricted (ID-R).  Click on link for guidelines on obtaining authorization.

Diagnosis

Common Pathogens

Drug(s) of First Choice

Alternative Drug(s)

Comments

Prostatitis

Acute

Enterobacteriaceae (E. coli)

Cephalexin 500 mg PO QID x 21 days (SFVAMC only)

OR

Ciprofloxacin 500 mg PO BIDX 2-4 weeks*

OR

LevofloxacinID-R: VASF 500 mg PO daily x 2-4 weeks*

Trimethoprim/ Sulfamethoxazole 1 DS tablet PO BID 

Antibiotic penetration in the acute inflammatory state is adequate for most antibiotics.

 

Consider sexually transmitted disease treatment (Gonococcus or C. trachomatis) for appropriate patient populations.

 

*Cultures should be obtained and definitive therapy should be based on sensitivities. 

Prostatitis

Chronic 

Enterobacteriaceae (E. coli)

Ciprofloxacin x 2 months*

OR

LevofloxacinID-R: VASF x 2 months* 

Trimethoprim/ Sulfamethoxazole 1 DS tablet PO BID

Few drugs penetrate non-inflamed prostate. Fluoroquinolones and trimethoprim/sulfamethoxazole adequately penetrate in non-inflamed state.

 

Consider sexually transmitted disease treatment (Gonococcus or C. trachomatis) for appropriate patient populations.

 

Consider urologic evaluation.

 

*Cultures should be obtained and definitive therapy should be based on sensitivities.