Acute bacterial prostatitis can be cured with antibiotics while chronic prostatitis cannot be cured by antibiotics.
Why is this the case?
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There are multiple types of prostatitis:
Source: Krieger JN, Nyberg, Jr L, Nickel JC. NIH Consensus Definition and Classification of Prostatitis. JAMA. 1999;282(3):236–237. doi:10-1001/pubs.JAMA-ISSN-0098-7484-282-3-jac90006
Also: J. Curtis Nickel (1999). Textbook of prostatitis. Taylor & Francis. pp. 28. ISBN 978-1-901865-04-2.
Prostatitis Type III and IV are non-bacterial, and as antibiotics are successful at killing bacteria, usage of it has been debated.
Pathogenic organisms can be cultured only in acute and chronic bacterial prostatitis. These conditions should be treated with antibiotics, usually fluoroquinolones, for an adequate period of time. 90% of patients with prostatitis syndrome, however, suffer not from bacterial prostatitis but from chronic (abacterial) prostatitis / chronic pelvic pain syndrome (CP/CPPS). It remains unclear whether CP/CPPS is of infectious origin, and therefore the utility of a trial of antimicrobial treatment is debatable. Treatment with alpha receptor blockers is recommended if functional subvesical obstruction is documented or suspected. Symptomatic therapy for pelvic pain should be given as well.
- Alpha-receptor blocker therapy for newly diagnosed patients not previously treated with alpha-blockers
- Antimicrobial therapy for newly diagnosed patients not previously treated with antibiotics
- Multimodal symptomatic therapy
Not recommended therapies
- Alpha-receptor blockers for patients with prior multiple therapies
- Anti-inflammatory monotherapy
- Antimicrobial therapy for patients with prior multiple therapies
- 5-alpha-reductase inhibitor monotherapy
- Minimally invasive therapies, such as TUNA, laser therapies, etc.
- Invasive surgical therapies, such as TURP and radical prostatectomy
Source: Florian ME Wagenlehner et al., Dtsch Arztebl Int. Prostatitis and Male Pelvic Pain Syndrome: Diagnosis and Treatment, 2009 Mar; 106(11): 175–183
Other studies are less critical:
Our review suggests that α-blockers, antibiotics, or combinations of both are most appropriate for therapy of CP/CPPS, particularly for patients with voiding symptoms. However, the magnitude of apparent benefit with α-blockers may be distorted by publication bias. Anti-inflammatory medications remain an option for patients presenting with pain. While finasteride and phytotherapy may provide benefit to some patients, these therapies require more evaluation, perhaps in selected subgroups of CP/CPPS patients.
Source: Anothaisintawee, T; Attia, J; Nickel, JC; Thammakraisorn, S; Numthavaj, P; McEvoy, M; Thakkinstian, A (Jan 5, 2011). "Management of chronic prostatitis/chronic pelvic pain syndrome: a systematic review and network meta-analysis". JAMA: the Journal of the American Medical Association. 305 (1): 78–86. doi:10.1001/jama.2010.1913. PMID 21205969.