Overview
Acute bacterial prostatitis is an infection of the prostate gland. It can present with lower urinary tract symptoms and systemic signs of infection.Diagnosis
Diagnosis is typically based on clinical presentation including fever, chills, malaise, dysuria, frequency, urgency, and perineal pain 1.
Laboratory findings may include leukocytosis and pyuria 1.
Urine culture is essential for identifying the causative organism and guiding antibiotic therapy 1.Management
Antibiotic therapy is the cornerstone of treatment for acute bacterial prostatitis 1.
Empirical antibiotic selection should cover common uropathogens, including Gram-negative bacteria 1.
Duration of therapy is typically 2 to 4 weeks, though longer courses may be necessary 1.
Adjunctive measures may include analgesics and anti-inflammatories for symptom relief 1.
In cases of urinary retention, temporary urinary diversion may be required 1.Key Recommendations
Antibiotic therapy is indicated for acute bacterial prostatitis 1. (Evidence: Strong)
Empirical antibiotic selection should consider likely pathogens and local resistance patterns 1. (Evidence: Moderate)
Transperineal prostate biopsy without antibiotic prophylaxis may have a lower rate of infectious complications compared to transrectal biopsy with targeted prophylaxis 1. (Evidence: Strong)References
1 Hu JC, Assel M, Allaf ME, Ehdaie B, Vickers AJ, Cohen AJ et al.. Transperineal Versus Transrectal Magnetic Resonance Imaging-targeted and Systematic Prostate Biopsy to Prevent Infectious Complications: The PREVENT Randomized Trial. European urology 2024. link