September 8, 1975

Trimethoprim-Sulfamethoxazole Therapy for Prostatitis

Author Affiliations

Stanford University Medical Center Stanford, Calif

JAMA. 1975;233(10):1048-1049. doi:10.1001/jama.1975.03260100018009

To the Editor.—  The article by Donald O. Schiffman (231:635, 1975) describes the new antibacterial combination drug, trimethoprim-sulfamethoxazole (Bactrim, Septra) and in passing cites its usefulness in the therapy of prostatitis. If physicians are to use trimethoprim-sulfamethoxazole in treating prostatitis, we feel compelled to share our observations regarding the use of this drug in treating chronic bacterial prostatitis.In general, two major types of chronic prostatitis are clinically recognized today: chronic bacterial prostatitis, where a specific bacterial pathogen can be identified by proper culture techniques, and nonbacterial prostatitis, where no pathogen can be isolated.1 The latter condition is the more common of the two types, is not associated with bacteriuria, and does not respond to antibacterial therapy, including trimethoprim-sulfamethoxazole. Chronic bacterial prostatitis, however, is probably the most common cause of relapsing urinary tract infection in men.2 Since the treatment of the two conditions is entirely different, bacteriologic localization