Prostatitis: Difference between revisions
| Line 30: | Line 30: | ||
##4-6 wk course | ##4-6 wk course | ||
##Cipro 500mg PO BID OR | ##Cipro 500mg PO BID OR | ||
##Bactrim DS 1 tab PO BID (less expensive but also less efficacious) | ##[[Bactrim DS]] 1 tab PO BID (less expensive but also less efficacious) | ||
#IV antibiotics | #IV antibiotics | ||
##Cipro 400mg IV q12 OR Levofloxacin 500mg IV q24 | ##Cipro 400mg IV q12 OR Levofloxacin 500mg IV q24 | ||
##OR Ceftriaxone 2g IV q24 +/- Gentamycin 3-5mg/kg/day | ##OR [[Ceftriaxone]] 2g IV q24 +/- Gentamycin 3-5mg/kg/day | ||
==Disposition== | ==Disposition== | ||
Revision as of 05:30, 27 February 2014
Background
- E. coli involved in 80% of cases
- Risk factors:
- Urinary Tract Obstruction
- Epididymitis
- Urethritis
- Unprotected rectal intercourse
- Phimosis
- Indwelling urethral catheter
Diagnosis
Acute Prostatitis
- Clinical diagnosis (UA and Ucx may be normal)
- Dysuria/urgency/frequency, perineal pain/low back pain, fever
- Rectal exam: Exquisitely tender and boggy prostate
Chronic Prostatitis
- Similar to acute prostatitis with exception of fever/chills
- Rectal exam is often unremarkable
Work-Up
- UA, Ucx
DDx
Treatment
- Abx
- 4-6 wk course
- Cipro 500mg PO BID OR
- Bactrim DS 1 tab PO BID (less expensive but also less efficacious)
- IV antibiotics
- Cipro 400mg IV q12 OR Levofloxacin 500mg IV q24
- OR Ceftriaxone 2g IV q24 +/- Gentamycin 3-5mg/kg/day
Disposition
- Admit toxic pts or pts with Urinary Retention
- Urology f/u
Source
Rosens, Tintinalli