Prostatitis, acute
- Always ensure urine and blood cultures have been sent PRIOR to commencement of antibiotics
- Treat for 14 days, then review. Consider a further 14 days if needed based on symptoms, examination, blood tests and cultures.
- Referral to Urology recommended
- Sexual health screening is strongly recommended
- Oral therapy is preferred
- For patients with penicillin allergy label consider penicillin allergy assessment and delabelling
NB: Always check microbiology results for susceptibility tests and treat accordingly.
Oral Therapy
co-trimoxazole 960mg po bd
OR
If susceptible on culture and sensitivity: trimethoprim 200mg po bd
If sexually transmitted infection is suspected: ADD doxycycline 100mg po bd and refer to Oxford Sexual Health Service (01865 231231) department for sexual health screening and contact tracing.
Preferred INTRAVENOUS therapy including non-severe, severe penicillin allergy or MRSA positive
co-trimoxazole 960mg iv bd
Consider adding gentamicin 5mg/kg iv single dose if suspected sepsis. If creatinine clearance less than 30 ml/min reduce dose to 3mg/kg.
If sexually transmitted infection is suspected: ADD doxycycline 100mg po bd refer to Oxford Sexual Health Service (01865 231231) department for sexual health screening and contact tracing.
Review IV daily and switch to oral when possible.
Alternative intravenous therapy
co-amoxiclav 1.2g iv tds
Consider adding gentamicin 5mg/kg iv single dose if suspected sepsis. If creatinine clearance less than 30 ml/min reduce dose to 3mg/kg.
If sexually transmitted infection is suspected: ADD doxycycline 100mg po bd refer to Oxford Sexual Health Service (01865 231231) department for sexual health screening and contact tracing.
OR
ceftriaxone 2g iv od
Consider adding gentamicin 5mg/kg iv single dose if suspected sepsis. If creatinine clearance less than 30 ml/min reduce dose to 3mg/kg.
If sexually transmitted infection is suspected: ADD doxycycline 100mg po bd refer to Oxford Sexual Health Service (01865 231231) department for sexual health screening and contact tracing.
Review daily and switch to oral when possible.