Chronic bacterial prostatitis - Revision history

Aidan at 12:06, 4 January 2023

2023-01-04T12:06:48Z

← Older revision		Revision as of 12:06, 4 January 2023
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	*First-line treatment is [[fluoroquinolones]] for 4 to 6 weeks		*First-line treatment is [[fluoroquinolones]] for 4 to 6 weeks
			**[[Ciprofloxacin]] 500 mg p.o. twice daily
⚫	*Alternatives include ~~[[fosfomycin]]~~ or ~~[[TMP-SMX]]~~
			**[[Levofloxacin]] 500 to 750 mg p.o. daily
		⚫	*Alternatives include, in order of preference:
			**[[TMP-SMX]] DS 1 tablet p.o. twice daily for 6 weeks
			**[[Doxycycline]] 100 mg p.o. twice daily for 6 weeks
			**[[Fosfomycin]] 3 g p.o. every 1 to 3 days for 6 weeks
			*For chlamydial prostatitis, [[azithromycin]] 500 mg p.o. daily (or for 3 consecutive days every week) for 3 weeks
	*Acutely ill patients should be treated with a third-generation [[Cephalosporins\|cephalosporin]] or [[Carbapenems\|carbapenem]]		*Acutely ill patients should be treated with a third-generation [[Cephalosporins\|cephalosporin]] or [[Carbapenems\|carbapenem]]
			*Test-of-cure generally not needed

	[[Category:Genitourinary infections]]		[[Category:Genitourinary infections]]

Aidan: Text replacement - " species]]" to "]]"

2022-01-27T03:40:32Z

Text replacement - " species]]" to "]]"

← Older revision		Revision as of 03:40, 27 January 2022
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	*[[Enterobacterales]]		*[[Enterobacterales]]
	*[[Pseudomonas ~~species~~]]		*[[Pseudomonas]]
	*Occasionally, [[Enterococcus ~~species~~]]		*Occasionally, [[Enterococcus]]

	==Clinical Manifestations==		==Clinical Manifestations==

Aidan: /* Management */

2020-09-14T18:20:32Z

Management

← Older revision		Revision as of 18:20, 14 September 2020
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	== Background ==		==Background==

	=== Microbiology ===		===Microbiology===

	* [[Enterobacterales]]		*[[Enterobacterales]]
	* [[Pseudomonas species]]		*[[Pseudomonas species]]
	* Occasionally, [[Enterococcus species]]		*Occasionally, [[Enterococcus species]]

	== Clinical Manifestations ==		==Clinical Manifestations==

	* Mild to moderate pelvic pain symptoms with recurrent [[Urinary tract infection\|urinary tract infections]], typically with the same organism		*Mild to moderate pelvic pain symptoms with recurrent [[Urinary tract infection\|urinary tract infections]], typically with the same organism
	* Prostate is usually normal on physical or endoscopic assessment		*Prostate is usually normal on physical or endoscopic assessment

	== Diagnosis ==		==Diagnosis==

	* The gold standard is the 4-glass test		*The gold standard is the 4-glass test
	** Sample 1: first void (5-10 mL)		**Sample 1: first void (5-10 mL)
	** Sample 2: midstream		**Sample 2: midstream
	** Sample 3: expressed prostatic secretions		**Sample 3: expressed prostatic secretions
	** Sample 4: first void after prostatic massage (5-10 mL)		**Sample 4: first void after prostatic massage (5-10 mL)
	** Positive if sample 4 has ≥10 times the colony count of sample 1		**Positive if sample 4 has ≥10 times the colony count of sample 1
	* Can also do 2-glass pre- and post-massage test		*Can also do 2-glass pre- and post-massage test
	** Sample 1: midstream urine (10 mL)		**Sample 1: midstream urine (10 mL)
	** Sample 2: first void after prostate massage (10 mL)		**Sample 2: first void after prostate massage (10 mL)
	** Positive if sample 2 has ≥10 times the colony count of sample 1		**Positive if sample 2 has ≥10 times the colony count of sample 1
	* Semen cultures are not recommended		*Semen cultures are not recommended
	* Prostatic ultrasonography is not recommended		*Prostatic ultrasonography is not recommended

	== Management ==		==Management==

	* First-line treatment is [[fluoroquinolones]] for 4 to 6 weeks		*First-line treatment is [[fluoroquinolones]] for 4 to 6 weeks
	* Alternatives include [[fosfomycin]]		*Alternatives include [[fosfomycin]] or [[TMP-SMX]]
	* Acutely ill patients should be treated with a third-generation [[Cephalosporins\|cephalosporin]] or [[Carbapenems\|carbapenem]]		*Acutely ill patients should be treated with a third-generation [[Cephalosporins\|cephalosporin]] or [[Carbapenems\|carbapenem]]

	[[Category:Genitourinary infections]]		[[Category:Genitourinary infections]]

Aidan: Created page with "== Background == === Microbiology === * Enterobacterales * Pseudomonas species * Occasionally, Enterococcus species == Clinical Manifestations == * Mild to mod..."

2020-09-14T18:19:45Z

Created page with "== Background == === Microbiology === * Enterobacterales * Pseudomonas species * Occasionally, Enterococcus species == Clinical Manifestations == * Mild to mod..."

New page

== Background ==

=== Microbiology ===

* [[Enterobacterales]]
* [[Pseudomonas species]]
* Occasionally, [[Enterococcus species]]

== Clinical Manifestations ==

* Mild to moderate pelvic pain symptoms with recurrent [[Urinary tract infection|urinary tract infections]], typically with the same organism
* Prostate is usually normal on physical or endoscopic assessment

== Diagnosis ==

* The gold standard is the 4-glass test
** Sample 1: first void (5-10 mL)
** Sample 2: midstream
** Sample 3: expressed prostatic secretions
** Sample 4: first void after prostatic massage (5-10 mL)
** Positive if sample 4 has ≥10 times the colony count of sample 1
* Can also do 2-glass pre- and post-massage test
** Sample 1: midstream urine (10 mL)
** Sample 2: first void after prostate massage (10 mL)
** Positive if sample 2 has ≥10 times the colony count of sample 1
* Semen cultures are not recommended
* Prostatic ultrasonography is not recommended

== Management ==

* First-line treatment is [[fluoroquinolones]] for 4 to 6 weeks
* Alternatives include [[fosfomycin]]
* Acutely ill patients should be treated with a third-generation [[Cephalosporins|cephalosporin]] or [[Carbapenems|carbapenem]]

[[Category:Genitourinary infections]]