What are the first-line antibiotic treatments for acute prostatitis, and how long should they be prescribed?

First-line antibiotic treatments for acute prostatitis: The recommended first-line antibiotics are fluoroquinolones, specifically ciprofloxacin or ofloxacin, as they achieve therapeutic levels in the prostate and are appropriate for this severe infection.

Recommended duration of therapy: Initial treatment is typically oral antibiotics if the patient can tolerate them and the condition is not severe enough to require intravenous therapy. The total duration of antibiotic therapy is usually 2 to 4 weeks, with reassessment after 14 days to decide whether to stop or continue treatment for an additional 14 days. In some cases, treatment may be required for up to 6 weeks based on clinical assessment.

Additional notes: If the patient cannot take oral antibiotics or the infection is severe, intravenous antibiotics may be required initially. Patients should be reassessed if symptoms do not improve within 48 hours, and referral to hospital or specialist care may be necessary.

These recommendations are based on NICE guidelines and the European Association of Urology, with caution advised regarding fluoroquinolone use due to potential serious side effects, but their use is justified in acute prostatitis due to the severity of the infection.

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