Tailored management of chronic bacterial prostatitis with sequential fluoroquinolones and adverse effect mitigation strategies: A case report

Chronic bacterial prostatitis (CBP) presents diagnostic and therapeutic challenges, particularly in patients with drug allergies and atypical symptom profiles. This case describes a retired male healthcare professional with exclusive penile pain and urinary symptoms, diagnosed with CBP. Management involved sequential fluoroquinolone therapy-ciprofloxacin followed by moxifloxacin-over 6.5 weeks, guided by clinical condition and pharmacokinetic/ pharmacodynamic (PK/PD) considerations. To mitigate adverse drug reaction (ADR) risks, the patient incorporated probiotics, tendon support measures, and QT monitoring. The individualized approach resulted in significant symptomatic improvement without complications. Follow-up focused on prostate-specific antigen (PSA) monitoring, symptom tracking, and referral to pelvic floor physical therapy. This case's approach combining sequential fluoroquinolone therapy with structured ADR-prevention strategies and a patient-engaged, shared decision-making model underscores the importance of individualized, multidisciplinary care in CBP.