Prostatitis: the role of antibiotic treatment

The prostatitis syndrome is commonly found in urologic practice and is classified according to the NIDDK/NIH, in which bacterial prostatitis (acute and chronic) is distinguished from chronic pelvic pain syndrome (CPPS). In acute bacterial prostatitis (NIH category I), antibiotic treatment is mandatory and successful in most cases. In chronic bacterial prostatitis (NIH category II), antibiotics must be selected according to suitable pharmacokinetic/pharmacodynamic parameters and therapy should be prolonged. The success varies according to the etiologic pathogen and the course of the infection. In inflammatory CPPS (NIH category IIIA) antibiotics can be tried initially and continued, if symptoms improve. There is no consensus regarding the role of antibiotic treatment in patients with non-inflammatory CPPS (NIH category IIIB) and asymptomatic prostatitis (NIH category IV).