Medical Treatment

• Acute bacterial prostatitis

• Antibiotics: You likely will be given trimethoprim-sulfamethoxazole (Bactrim, Septra) or fluoroquinolones (ciprofloxacin, norfloxacin, ofloxacin) for 4-6 weeks.
  
  
  • If you have a high fever or symptoms of a severe bacterial infection, you may be hospitalized.
    
    
  • At the hospital, you may be given cephalosporins or ampicillin plus an aminoglycoside (gentamicin, amikacin).
    
    
  • Sometimes you may need a catheter (a small tube inserted through your urethra) for severe obstructions.
    
    

• Chronic bacterial prostatitis

• The effectiveness of antibiotics is limited because most antibiotics cannot penetrate the prostate tissue when it is not inflamed.
  
  
  • You likely will receive sulfamethoxazole and trimethoprim (Bactrim DS, Septra DS) first. Other effective antibiotics include ciprofloxacin (Cipro), norfloxacin (Noroxin), or ofloxacin (Floxin).
    
    
  • Many men have a relapse, however, after they stop taking antibiotics. These men may need a longer course of antibiotics.

• If you have a relapse or a resistant disease, your doctor may continue your antibiotics with prostatic massage or drainage (2 or 3 times per week).
  
  
  • The involved ducts and glands may be blocked, creating tiny pockets almost like abscesses.
    
    
  • It is believed that prostate massage unblocks these ducts, allowing them to drain more normally, thus permitting better penetration of antibiotics.

• You rarely need surgery, which may be considered if medication has not worked.