Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
Patient education for acute prostatitis management and potential complications should include:
- Antibiotic treatment: Explain the importance of completing the full course of prescribed antibiotics, typically ciprofloxacin or ofloxacin for 14 days, or trimethoprim if fluoroquinolones are unsuitable. Emphasise that treatment may last several weeks and may require extension up to 6 weeks based on clinical assessment NICE CKS.
- Adverse effects of antibiotics: Inform about possible side effects, especially serious adverse reactions related to fluoroquinolones, such as tendonitis, tendon rupture, muscle and joint pain, peripheral neuropathy, and central nervous system effects. Advise to stop the antibiotic immediately and seek medical advice if these occur NICE CKS. Provide the patient information sheet on fluoroquinolone side effects NICE CKS.
- Symptom monitoring and when to seek help: Advise patients to seek medical help if symptoms worsen at any time, do not improve within 48 hours of starting antibiotics, or if they become systemically very unwell, as these may indicate complications like acute urinary retention, prostatic abscess, or sepsis NICE CKS.
- Pain management: Recommend use of paracetamol with or without a low-dose weak opioid (e.g., codeine) or ibuprofen if preferred and suitable for pain relief NICE CKS.
- Hydration: Encourage drinking sufficient fluids to avoid dehydration NICE CKS.
- Follow-up: Arrange follow-up after 48 hours to assess response to treatment and review urine culture results, adjusting antibiotics if resistance is detected NICE CKS.
- Referral and hospital admission: Explain that hospital admission may be necessary if oral antibiotics cannot be taken, symptoms are severe, or complications develop. Urgent referral is advised for immunocompromised patients, those with diabetes, or pre-existing urological conditions NICE CKS.
- Post-recovery investigation: Inform that after recovery, further investigations may be needed to exclude structural abnormalities of the urinary tract NICE CKS.