Clinical recommendation	Evidence rating	References	Comments
Prostatic massage should be avoided in patients suspected of having acute bacterial prostatitis.	C	11, 12, 20, 22	Expert consensus
Midstream urine culture should be used to guide antibiotic therapy for acute bacterial prostatitis.	C	3, 10, 11	Prospective cohort study, retrospective cohort study
Blood cultures are indicated in patients with a body temperature greater than 101.1°F (38.4°C), a possible hematogenous source of infection (e.g., endocarditis with Staphylococcus aureus), or complicated infections (e.g., sepsis), and in patients who are immunocompromised.	C	21	Prospective cohort study
Prostate-specific antigen testing is not indicated in the evaluation of acute bacterial prostatitis.	C	11, 12, 20	Prospective cohort study
Fevers that persist for longer than 36 hours should be evaluated with imaging to rule out prostatic abscess.	C	27	Expert opinion
Acute bacterial prostatitis occurring after a transrectal prostate biopsy should be treated with broad-spectrum antibiotics to cover fluoroquinolone-resistant bacteria and extended spectrum beta-lactamase–producing Escherichia coli.	C	15–18, 24	Multiple retrospective cohort studies and one prospective cohort study