Treatment
Treatment requires prolonged courses (4–8 weeks) of antibiotics that penetrate the prostate well. These include nitrofurantoin, quinolones (ciprofloxacin, levofloxacin), sulfas (Bactrim, Septra), doxycycline and macrolides (erythromycin, clarithromycin). Persistent infections may be helped in 80% of patients by the use of alpha blockers (tamsulosin (Flomax), alfuzosin), or long term low dose antibiotic therapy. Recurrent infections may be caused by inefficient urination (benign prostatic hypertrophy, neurogenic bladder), prostatic stones or a structural abnormality that acts as a reservoir for infection.
Escherichia coli extract and cranberry have a potentially preventive effect on the development of chronic bacterial prostatitis.
The addition of prostate massage to courses of antibiotics was previously proposed as being beneficial. However, in more recent trials, this was not shown to improve outcome compared to antibiotics alone.
Read more about this topic: Chronic Bacterial Prostatitis
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—Raymond Chandler (1888–1959)