Prostatitis

Prescribing Notes:

• Refer to BNF important safety information for all quinolones prior to prescribing.
• See MHRA Drug Safety Update (January 2024): Fluoroquinolones must only be used in situations when other antibiotics, that are commonly recommended for the infection, are inappropriate such as:
  
  • there is resistance to other first-line antibiotics recommended for the infection
  • other first-line antibiotics are contraindicated in an individual patient
  • other first-line antibiotics have caused side effects in the patient requiring treatment to be stopped
  • treatment with other first-line antibiotics has failed
• Send MSU for culture and start treatment.
• Advise paracetamol (+/- low-dose weak opioid) for pain, or ibuprofen if preferred and suitable.
• Review antibiotic treatment after 14 days and either stop antibiotics or continue for a further 14 days if needed (based on assessment of history, symptoms, clinical examination, urine and blood tests).
• Intravenous antibiotics may be indicated if unable to take oral antibiotics or severely unwell, refer to NICE guideline above.
• With any genital symptoms consider a sexually transmitted infection (STI) test including chlamydia, gonorrhoea, HIV and syphilis.
• Co-trimoxazole 80mg/400mg tablets are more cost-effective dose for dose than 160mg/800mg tablets.
• Ciprofloxacin 250mg tablets are more cost-effective dose for dose than 500mg tablets.