acute prostatitis

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Acute bacterial prostatitis is an acute focal or diffuse suppurative inflammation of the prostate gland.

Acute prostatitis is a bacterial infection needing prompt treatment with antibiotics.

Gram-negative bacteria are the most common causative pathogens in acute prostatitis, most commonly (1)

  • Escherichia coli,
  • Proteus species,
  • Klebsiella species and
  • Pseudomonas species

The prostate is usually involved as a consequence of:

  • direct extension from the posterior urethra or urinary bladder
  • distant spread in the blood or lymphatics

Occasionally, infection may spread from the rectum.

Complications of acute prostatitis include:

  • acute urinary retention secondary to prostatic oedema,
  • chronic prostatitis,
  • prostatic abscess,
  • bacteraemia,
  • epididymitis and
  • pyelonephritis

Notes:

  • in England, resistance of E. coli (the main causative organism of acute prostatitis) in laboratory processed urine specimens to the following antibiotics is:
    • ciprofloxacin: 10.6% (varies by area from 7.8% to 13.7%)
    • trimethoprim: 30.3% (varies by area from 27.1% to 33.4%) (Public Health England. Antimicrobial resistance quarterly surveillance: March 2018)

Reference:

Last edited 11/2018 and last reviewed 03/2020

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