This protocol addresses adults aged 18 and over with acute bacterial prostatitis who are able to take oral medicines and whose condition does not require intravenous antibiotics — but for whom fluoroquinolone antibiotics are not appropriate.
This protocol applies when all of the following are present:
An antibiotic should be offered. When prescribing, local antimicrobial resistance data must be taken into account. Oral antibiotics are given first line where the above criteria are met, and antibiotic selection in this scenario should be guided by local susceptibilities when available and informed by specialist advice.
An oral antibiotic is the recommended first-line management, with the choice of agent guided by susceptibility data when available. The regimen includes a structured review point, at which continuation may be considered based on clinical assessment.
Full antibiotic selection, dosing, and review criteria are set out in the complete protocol.
If symptoms worsen at any time or do not begin to improve within 48 hours, prompt reassessment is needed.
Offer an antibiotic to people with acute prostatitis.
When prescribing an antibiotic for acute prostatitis, take account of local antimicrobial resistance (AMR) data from Public Health England and follow table 1 for adults aged 18 years and over.
Give oral antibiotics first line if the person can take oral medicines, and the severity of their condition does not require intravenous antibiotics.
Alternative first-choice oral antibiotic if a fluoroquinolone antibiotic is not appropriate (seek specialist advice; guided by susceptibilities when available).
Review antibiotic treatment after 14 days and either stop the antibiotic or continue for a further 14 days if needed, based on an assessment of the person's history, symptoms, clinical examination, urine and blood tests.
Continued symptoms, such as fever or lower urinary tract symptoms (dysuria, frequency, urgency, or acute urinary retention) require ongoing treatment.
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