BASHH. UK National Guidelines for the Management of Prostatitis. British Association for Sexual Health and HIV. 2008. RATIONALE: MSU for all men: acute prostatitis is a severe illness. It is important that an MSU is sent for culture and sensitivities to ensure that an appropriate antibiotic is used. Treatment regimens: there are no randomized controlled trials of quinolines or trimethoprim for the treatment of prostatitis. Expert opinion is that, for men with acute prostatitis who are suitable for oral antibiotic treatment, ciprofloxacin 500mg BD for 28 days or ofloxacin 200mg BD for 28 days will provide sufficient levels within the prostate gland. Expert opinion is that trimethoprim 200mg BD for 28 days is a suitable alternative for men who are intolerant or allergic to quinolones. Duration of treatment: the optimum duration of treatment is unknown. Expert opinion is that a 4-week course of antibiotics is required to reduce the risk of developing chronic bacterial prostatitis.
Micromedex. Drugdex drug evaluations. Thompson Healthcare. 2009. RATIONALE: Trimethoprim reaches good concentrations in prostatic tissue (peak prostate concentration was reported to be 2.3 mcg/g 280 minutes after an oral dose compared with serum levels of 2.2mcg/mL at 125 minutes after an oral dose). Ciprofloxacin reaches high concentrations in prostatic fluid, often exceeding serum levels (at 2 to 4 hours following oral administration, prostatic fluid levels ranged from 0.02 to 5.5 mcg/mL compared with serum levels of 1 to 2.5 mcg/mL. Ofloxacin also reaches high concentrations in prostatic fluid (at 1 to 4 hours following oral administration prostatic guide levels ranged from 3.22 to 4.25 mcg/g.