Medications

Treatment of prostatitis usually begins with antibiotics and possibly other medicines to relieve symptoms. If you begin to get better, you may have to continue taking antibiotics for 2 to 3 months. During this time, be sure to take the antibiotics as prescribed. If you do not begin to get better while taking medicines, your doctor may want you to have more tests.

Medication Choices

Acute and chronic bacterial prostatitis

Antibiotics are central to treating acute or chronic bacterial prostatitis. Your doctor may prescribe certain antibiotics based on your medical history, symptoms, and other factors such as your age. Other medicines may also be used to help control symptoms, including:

• Medicines to reduce pain, fever, and inflammation. These include nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen, or acetaminophen.
• Stool softeners, to prevent or eliminate constipation.

Chronic bacterial prostatitis may require long-term antibiotics, especially if the symptoms return. Some men need treatment with low doses of antibiotics over a long period to control infection and prevent repeated urinary tract infections (UTIs).

Chronic prostatitis/pelvic pain syndrome, inflammatory and noninflammatory

Chronic prostatitis/pelvic pain syndrome, inflammatory and noninflammatory, are usually treated first with antibiotics based on the possibility that an infection was missed during testing. But experts advise against long-term treatment with antibiotics unless an unusual bacterial infection is suspected.

Medicines that may be used to treat chronic prostatitis/pelvic pain syndrome, inflammatory or noninflammatory, include:

• Antibiotics. If the symptoms begin to improve, it is possible that an undiagnosed infection is responsible for the symptoms.
• Medicines that reduce pain and inflammation (nonsteroidal anti-inflammatory drugs (NSAIDs)).
• Medicines that relax muscles throughout the body (muscle relaxants) or that relax muscles in the prostate (alpha-blockers).
• Medicines that slow the growth of the prostate (5-alpha reductase inhibitors).
• Medicines that reduce anxiety (benzodiazepines). These medicines also may relax the muscles around the prostate and make it easer to urinate. These medicines work best when combined with counseling.
• Medicines that are used for chronic pain (anticonvulsants).

What to think about

Prostate stones (prostatic calculi) can make chronic bacterial prostatitis more difficult to cure. If you have prostate stones, they may need to be surgically removed.