What is the first-line treatment for prostatitis?

The first-line treatment for acute bacterial prostatitis is ciprofloxacin, which is a fluoroquinolone antibiotic. This choice is particularly effective due to its excellent penetration into prostatic tissue and its efficacy against common pathogens associated with prostatitis, such as Escherichia coli and other Enterobacteriaceae. Fluoroquinolones have a broad spectrum of activity and are effective against the gram-negative rods that are often implicated in these infections.

While trimethoprim-sulfamethoxazole may also be used in some cases, especially for chronic prostatitis or in patients with specific risk factors, fluoroquinolones like ciprofloxacin are generally preferred for acute cases due to their rapid onset and effectiveness against a wider range of potential pathogens.

The other options do not align with the standard of care for acute prostatitis. Ampicillin is less effective as it primarily targets gram-positive bacteria and does not adequately cover the common gram-negative causes. Vancomycin, while important in cases where methicillin-resistant Staphylococcus aureus (MRSA) is suspected, is not a first-line treatment for prostatitis as it does not target the typical pathogens involved.

Thus, ciprofloxacin stands out as the most appropriate and effective first