Therapy for prostatitis, with emphasis on bacterial prostatitis.

The prostatitis syndrome is classified in bacterial prostatitis as confirmed or suspected infection and chronic pelvic pain syndrome (CPPS). Bacterial prostatitis is a disease entity that is diagnosed clinically and by evidence of inflammation and infection localised to the prostate. According to the duration of symptoms, bacterial prostatitis is described as either acute or chronic. Acute bacterial prostatitis can be a serious infection and administration of high doses of bactericidal antibiotics are required. In chronic bacterial prostatitis, and if infection is strongly suspected in CPPS, a fluoroquinolone should be administered initially for 2 weeks. Antibiotics should only be continued for a total of approximately 4-6 weeks, if pre-treatment cultures are positive and/or the patient has reported positive effects from the treatment. Patients with CPPS are treated empirically with various medical and physical modalities. Until now, despite the existence of some scientifically valid studies, no definite recommendations have been made because patients with CPPS are most likely to represent a heterogeneous group of diseases and therapeutic outcome is always uncertain.