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Treating Chronic Prostatitis: Antibiotics No, α-Blockers Maybe
Prostatitis is a common cause of visits to a physician. The National Institutes of Health (NIH) consensus classification of prostatitis syndromes includes acute bacterial prostatitis (type I), chronic bacterial prostatitis (type II), chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) (type III), and asymptomatic inflammatory prostatitis (type IV) (1). Type III, by far the most common of these syndromes, presents in 2 forms. Type III A is inflammatory, as shown by leukocytes in expressed prostatic secretions, post–prostate massage urine, or semen. Type III B is noninflammatory, and leukocytes are not present in these fluids. The cause of CP/CPPS is not known.
Therapeutic strategies for patients with CP/CPPS frequently include antibiotic drugs and α-blockers. In the NIH prioritization index, both treatment categories are ranked number 1 and 2 (2). Although many urologists routinely prescribe antimicrobial agents for patients presenting with CP/CPPS, the emerging consensus is that antibiotics do not play any …
