What is the antibiotic of choice for acute prostatitis?

The antibiotic of choice for acute prostatitis is Ciprofloxacin, commonly referred to as Cipro. This fluoroquinolone antibiotic is particularly effective against the bacteria typically associated with this condition, specifically Gram-negative organisms such as Escherichia coli, which is the most common pathogen involved in acute prostatitis cases.

Ciprofloxacin is preferred due to its good tissue penetration, including the prostate, and its effectiveness in resolving bacterial infections in the urinary tract. The ability of Cipro to reach adequate concentrations in the prostate makes it a suitable choice for treating acute bacterial prostatitis.

Other antibiotics listed, like Flagyl, are primarily effective against anaerobic bacteria and are not typically used for prostatitis. Keflex is a cephalosporin that addresses certain bacterial infections but lacks the spectrum of activity required for acute prostatitis. Azithromycin, though effective against some bacterial infections, is not the first line for this specific condition, as it doesn't provide adequate coverage for the organisms commonly causing acute prostatitis. Therefore, Ciprofloxacin stands out as the most appropriate treatment option among the choices provided.