Acute bacterial prostatitis

Gram-negative enteric organisms are the most frequent pathogens in acute bacterial prostatitis. E. coli is the predominant organism, occurring in 75% of cases. 

Acute bacterial prostatitis High fever, chills, malaise, myalgia, localized pain (perineal, rectal, sacrococcygeal), frequency, urgency, dysuria, nocturia, and retention Chronic bacterial prostatitis Voiding difficulties (frequency, urgency, dysuria), low back pain, and perineal and suprapubic discomfort Physical examination... 

Acute bacterial prostatitis Swollen, tender, tense, or indurated gland Chronic bacterial prostatitis Boggy, indurated (enlarged) prostate in most patients Laboratory tests Bacteriuria... 

Acute bacterial exacerbation of chronic bronchitis/community-acquired pneumonia/acute maxillary sinusitis/uncomplicated SSSI/chronic bacterial prostatitis... 

Acute bacterial prostatitis can be managed with many agents that have activity against the causative organism. Chronic prostatitis requires an agent that is not only active against the causative organism but also concentrates in the prostatic secretions. Therapy with trimethoprim-sulfamethoxazole or a fluoroquinolone is preferred for 4 to 6 weeks. 

Acute bacterial prostatitis presents as other acute infections (Table 114—6). Massage of the prostate will express a purulent discharge that will readily grow the pathogenic organism. Prostatic massage is contraindicated in acute bacterial prostatitis, however, because of the... 

Acute bacterial prostatitis High fever, chills, malaise, myalgia,... 

Levofloxacin is a fluoroquinolone/ophthalmic/antibiotic that interferes with microbial DNA synthesis. It is indicated in the treatment of acute maxillary sinusitis, acute bacterial exacerbation of chronic bronchitis, nosocomial pneumonia, community-acquired pneumonia, skin and skin structure infections, chronic bacterial prostatitis, urinary tract infection (UTI), inhalational anthrax (postexposure), and acute pyelonephritis caused by susceptible strains of specific microorganisms. Ophthalmic use is for the treatment of conjunctivitis caused by susceptible strains of aerobic Gram-positive and aerobic Gram-negative microorganisms. 

Chronic bacterial prostatitis occurs when acute bacterial prostatitis has been inadequately treated because of pathogen resistance, relapse, or short-course therapy or because of blocked drainage of secretions from the prostate. Most men with chronic prostatitis will have had a previous bout of acute prostatitis. The most common clinical feature of chronic prostatitis is recurrent urinary tract infections and the symptoms and complaints of acute bacterial prostatitis. Fluoroquinolones, trimethoprim-sulfamethoxazole, doxycycline, and nitrofurantoin are used in the management of chronic prostatitis. Chronic prostatitis warrants at least 10 to 12 weeks of therapy. Poor clinical outcomes, however, have been observed because of poor diffusion of antimicrobials into the prostate. 

Indications Bone and joint infections, bacterial bronchitis, endocervical and urethral chlamydia, bacterial gastroenteritis, endocervical and urethral gonorrhea, intra-abdominal infections, empiric therapy for febrife neutropenia, pelvic inflammatory disease, bacterial pneumonia, bacterial prostatitis, acute sinusitis, skin and soft tissue infections, typhoid fever, bacterial urinary tract infections, chancroid, meningococcal carriers, bacterial septicemia, prophylaxis in prevention of bacterial urinary tract infections Common drug examples ... 

Treatment of acute and chronic prostatitis - 160 mg TMP/800 mg SMZ twice daily has been used for chronic bacterial prostatitis for up to 12 weeks. 

The antibacterial spectrum of trimethoprim is similar to that of sulfamethoxazole (see p. 290) however, trimethoprim is 20 to 50 times more potent than the sulfonamide. Trimethoprim may be used alone in acute urinary tract infections and in the treatment of bacterial prostatitis (though fluoroquinolones are preferred). 

Carbenicillin is an extended-spectrum penicillin, that inhibits mucopeptide synthesis in bacterial cell wall. It is indicated in the treatment of acute and chronic infections of the upper and lower urinary tract, prostatitis, and asymptomatic bacteriuria caused by susceptible microorganisms. 

Ciprofloxacin is a fluoroquinolone antibiotic that interferes with microbial DNA synthesis. It is indicated in the treatment of infections of the lower respiratory tract, skin and skin structure, bones and joints, urinary tract gonorrhea, chancroid, and infectious diarrhea caused by susceptible strains of specific organisms typhoid fever uncomplicated cervical and urethral gonorrhea women with acute uncomplicated cystitis acute sinusitis nosocomial pneumonia chronic bacterial prostatitis complicated intra-abdominal infections reduction of incidence or progression of inhalational anthrax following exposure to aerosolized Bacillus anthracis. Cipro IV Used for empirical therapy for febrile neutropenic patients. 

Ofloxacin interferes with microbial DNA synthesis. It is indicated in the treatment of acnte bacterial exacerbations of chronic bronchitis, commnnity acquired pneumonia, uncomplicated skin and skin structure infections, acute uncomplicated urethral and cervical gonorrhea, nongonococcal urethritis, cervicitis, acute pelvic inflammatory disease, uncomplicated cystitis, complicated urinary tract infections (UTI), and prostatitis cdiV eAhy Escherichia coli. Ophthalmic use for treatment of conjunctivitis and corneal ulcer infections caused by susceptible organisms otic use for treatment of otitis externa, chronic suppurative otitis media in patients with perforated tympanic membranes, and acute otitis media in pediatric patients with tympanostomy tubes. 

Co-trimoxazole te.g., Bactrim or Septra) Inhibits the folate synthesis pathway at two different sites (Fig. 7.14). This increases the likelihood that bacteria will produce too little folate to effectively reproduce. Additionally, the likelihood of resistance is substantially reduced. Indicated for urinary tract infections, acute otitis, shigellosis, and Pneumocystis carinii pneumonitis in all age groups. In adults, it is also indicated for exacerbations of chronic bronchitis, bacterial prostatitis and traveller s diarrhea. 

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