Acute and chronic bacterial prostatitis are considered infections which are cumbersome to treat, due to the limited available selection of effective antibiotics and the pharmacologically poor distribution in prostatic tissue. Furthermore, the emergence of novel antimicrobial resistance patterns, such as extended spectrum β‑lactamase (ESBL)‑producing Escherichia coli (E. coli) along with increasing fluoroquinolone resistance poses major clinical concerns in selecting the appropriate therapy to treat and eradicate the infection, particularly considering the outpatient setting. The present study describes the case of a healthy male affected by a first acute bacterial prostatitis episode due to ESBL‑producing E. coli. The patient was successfully treated with oral fosfomycin‑trometamol administration, achieving clinical success with microbiological eradication. The case described in the present study, along with the literature review, encourage and suggest the use of oral fosfomycin for the treatment of both acute and chronic prostatitis, particularly for outpatients and for those subjects who cannot be administered other antibiotics.
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