Tailored management of chronic bacterial prostatitis with sequential fluoroquinolones and adverse effect mitigation...

Chronic bacterial prostatitis (CBP) presents diagnostic and therapeutic challenges, particularly in patients with drug allergies and atypical symptom profiles. This case describes a retired male healthcare professional with exclusive penile pain and urinary symptoms, diagnosed with CBP. Management involved sequential fluoroquinolone therapy-ciprofloxacin followed by moxifloxacin-over 6.5 weeks, guided by clinical condition and pharmacokinetic/ pharmacodynamic (PK/PD) considerations. To mitigate adverse drug reaction (ADR) risks, the patient incorporated probiotics, tendon support measures, and QT monitoring. The individualized approach resulted in significant symptomatic improvement without complications. Follow-up focused on prostate-specific antigen (PSA) monitoring, symptom tracking, and referral to pelvic floor physical therapy. This case's approach combining sequential fluoroquinolone therapy with structured ADR-prevention strategies and a patient-engaged, shared decision-making model underscores the importance of individualized, multidisciplinary care in CBP.