Prostatitis

Prescribing Notes:

• Refer to important safety information for all quinolones prior to prescribing.
• See MHRA Drug Safety Update January 2024: Fluoroquinolones must only be used in situations when other antibiotics, that are commonly recommended for the infection, are inappropriate such as:  
  • there is resistance to other first-line antibiotics recommended for the infection 
  • other first-line antibiotics are contraindicated in an individual patient 
  • other first-line antibiotics have caused side effects in the patient requiring treatment to be stopped 
  • treatment with other first-line antibiotics has failed.
• Feb 2024 local infection specialists have noted this section for review, further national guidance is anticipated.
• Refer to NICE guideline NG110 – Prostatitis (acute): antimicrobial prescribing.
• Send MSU for culture and start treatment.
• Advise paracetamol (+/- low-dose weak opioid) for pain, or ibuprofen if preferred and suitable.
• Review antibiotic treatment after 14 days and either stop antibiotics or continue for a further 14 days if needed (based on assessment of history, symptoms, clinical examination, urine and blood tests).
• Intravenous antibiotics may be indicated if unable to take oral antibiotics or severely unwell, refer to NICE guideline above.
• With any genital symptoms always consider the possibility of sexually transmitted infection (STI). People with risk factors should be screened for chlamydia, gonorrhoea, HIV and syphilis. Refer the individual and partners to sexual health service. Risk factors: younger patient, a new sexual partner or more than one sexual partner in the past year, lack of consistent condom use and a contact of a sexually transmitted infection.