title: Bacterial prostatitis.
abstract: OBJECTIVE
  The prostatitis syndrome is classified into bacterial prostatitis (acute and chronic), chronic pelvic pain syndrome and asymptomatic prostatitis. The aim of this report is to review current management standards for bacterial prostatitis.
  
  
  METHODS
  A research was performed on literature dealing with acute and chronic bacterial prostatitis.
  
  
  RESULTS
  There is a consensus on diagnostic management of bacterial prostatitis comprising microbiological sampling of midstream urine in acute bacterial prostatitis and performance of a bacterial localisation test in chronic bacterial prostatitis. Approximately 10 % of acute bacterial prostatitis cases eventually develop into chronic bacterial prostatitis and further 10 % into chronic pelvic pain syndrome. Bacterial isolates causing acute bacterial prostatitis are highly virulent strains comprising an array of different virulence factors. Presumably, the additional ability of isolates to form biofilms might be one factor amongst others to facilitate development of chronic bacterial prostatitis. Therapy for infectious prostatitis is standardised with antibiotics as the primary agents, empirically administered in acute prostatitis and after susceptibility testing in chronic bacterial prostatitis. Fluoroquinolones exhibit more favourable pharmacological properties; therefore, fluoroquinolones have been recommended as first-line agents in the treatment for chronic bacterial prostatitis. Antibiotic resistance to fluoroquinolones, however, is increasing and is posing significant clinical problems. Further studies on alternative antibiotics active within the prostate are therefore needed both for prophylaxis in transrectal prostate biopsy, for example, and for therapy of chronic bacterial prostatitis.
  
  
  CONCLUSIONS
  Bacterial prostatitis has developed into well-managed entities with increasing antimicrobial resistance being the most severe drawback of yielding therapeutic success.
authors.affiliation: Clinic of Urology, Pediatric Urology and Andrology, Justus-Liebig-University, Rudolf-Buchheim-Str. 7, 35385, Giessen, Germany. wagenlehner@aol.com
authors.forename: Florian M E
authors.initials: FM
authors.lastname: Wagenlehner
authors.forename: Adrian
authors.initials: A
authors.lastname: Pilatz
authors.forename: Thomas
authors.initials: T
authors.lastname: Bschleipfer
authors.forename: Thorsten
authors.initials: T
authors.lastname: Diemer
authors.forename: Thomas
authors.initials: T
authors.lastname: Linn
authors.forename: Andreas
authors.initials: A
authors.lastname: Meinhardt
authors.forename: Undraga
authors.initials: U
authors.lastname: Schagdarsurengin
authors.forename: Temujin
authors.initials: T
authors.lastname: Dansranjavin
authors.forename: Hans-Christian
authors.initials: HC
authors.lastname: Schuppe
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Weidner
mesh_terms: D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D002908:Chronic Disease; D018450:Disease Progression; D024881:Drug Resistance, Bacterial; D024841:Fluoroquinolones / Q000627:therapeutic use; D006801:Humans; D008297:Male; D011472:Prostatitis / Q000145:classification* / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones