What is the first-line treatment of choice for acute bacterial prostatitis?

The first-line treatment for acute bacterial prostatitis is commonly considered to be a fluoroquinolone, such as ciprofloxacin. This choice is based on several factors including the antibiotic's ability to penetrate prostatic tissue effectively, which is essential for treating infections in this area. Acute bacterial prostatitis is typically caused by Gram-negative bacteria, especially Escherichia coli, and fluoroquinolones have demonstrated strong activity against these pathogens.

Trimethoprim-sulfamethoxazole is also a possible treatment option for urinary tract infections, but it is not the first choice for acute bacterial prostatitis due to its limited tissue penetration compared to fluoroquinolones. Amoxicillin is more effective against certain types of bacteria but does not cover E. coli adequately for this condition. Doxycycline, while useful in treating infections caused by atypical organisms, does not provide the necessary coverage for the common pathogens responsible for acute bacterial prostatitis.

In summary, ciprofloxacin is favored in this clinical scenario due to its effectiveness against the usual causative organisms and its superior penetration into prostatic tissue, making it the appropriate first-line treatment choice.