臨床泌尿器科66巻11号

2012年10月発行

特集 古くて新しい前立腺炎の臨床

急性細菌性前立腺炎の治療

著者： 山本新吾¹ 東郷容和¹ 鈴木透¹

所属機関： ¹兵庫医科大学泌尿器科

ページ範囲：P.825 - P.829

要旨　急性細菌性前立腺炎の治療には，軽症例においては経口フルオロキノロンを，重症例においては十分な補液とともに第2～3世代セフェム系薬の静脈投与が推奨されている。不十分な治療では再発をきたしやすく，解熱した後も計2～4週間の抗菌薬治療が必要である。糖尿病や免疫不全などの全身性疾患，前立腺肥大症や神経因性膀胱などの尿路合併症があれば，同時に治療を行う必要がある。多量の残尿を伴う下部尿路通過障害をきたしている症例においては，膀胱瘻の造設または可能な限り細径の尿道カテーテルを使用する。前立腺膿瘍は，稀ではあるが迅速かつ確実な対応が望まれる。広域スペクトルの抗菌薬を投与するのみでなく，経尿道的開放術またはTRUSガイド下経会陰的・経直腸的穿刺吸引によるドレナージが必要である。

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