Prostatitis
Standard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 Edition
N41.1/N41.9 + (N34.2)
DESCRIPTION
Clinical features include:
- pyrexia,
- acute pain in the pelvis and perineum,
- dysuria and frequency,
- urinary retention or difficulty, and
- acutely tender prostate on rectal examination.
Chronic non-bacterial prostatitis
This is a diagnosis of exclusion, i.e. failure to respond to antibiotics. It is associated with perineal, suprapubic, penile and testicular pain.
MEDICINE TREATMENT
Acute bacterial prostatitis
If there are features of associated urethritis (STI regimen):
- Ceftriaxone, IM, 250 mg as a single dose.
LoE:IIIbxxxvii
AND
- Azithromycin, oral, 1 g as a single dose.
LoE:IIIbxxxviii
If there are no features of associated urethritis:
- Ciprofloxacin, oral, 500 mg 12 hourly for 14 days.
LoE:IVb
Chronic/relapse/persistent infection: N41.1
- Ciprofloxacin, oral, 500 mg 12 hourly for 28 days.
LoE:IVb
REFERRAL
To urologist if:
- No response to treatment.
- Urinary retention present.
- Chronic/relapsing prostatitis.
Standard Treatment Guidelines and Essential Medicines List for South Africa, Adult Hospital Level, 2020-2024_Version 1.0_17 October 2024
Chapter 7 Nephrology/Urological Disorders_7.3 Urological Disorders_7.3.4 Prostatitis