Approach to managing acute bacterial prostatitis

In addition to the factors informing empirical therapy for urinary tract infection (UTI) described in Approach to empirical antibiotic choice for UTI in adults , empirical therapy for acute bacterial prostatitis depends on the penetration of the antibiotic into the prostate and disease severity. Most antibiotics have good prostate penetration during the initial phase of intense inflammationLam, 2023Yebes, 2023 National Institute for Clinical Excellence (NICE), 2018.

For patients with sepsis or septic shock, see Sepsis and septic shock from a urinary tract source).

For patients who do not have sepsis or septic shock, initial oral antibiotic therapy can usually be used if the patient is able to tolerate and absorb oral therapyNational Institute for Clinical Excellence (NICE), 2018. For patients who cannot tolerate or absorb oral therapy, use initial intravenous antibiotic therapy.