10.有關前列腺炎感染之敘述，下列何者錯誤？
(A)常見致病菌種為 E.coli
(B)檢體只採取中段尿其中的 10 mL
(C)可使用 levofloxacin 250 mg QD 治療
(D)急性前列腺炎治療期間至少需 2～4 週

(A) E.Coli是前列腺炎最常見的致病菌（急性&慢性都是）

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Ref:Applied 12版

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(B)

確認前列腺炎感染需要採集3個尿液檢體！

1.最開始尿的前10mL：代表尿道樣本

2.中段尿液：代表膀胱樣本

3.前列腺按摩後尿的前10mL：代表前列腺樣本

*當膀胱樣本無菌，如果前列腺樣本中的細菌>尿道樣本中的細菌(用對數比較)，則診斷為細菌性前列腺炎。

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Applied 12版課本原文：「To ensure accurate localization (ie, to distinguish prostatic from urethral bacteria), segmented urine samples are taken. The first 10 mL of collected voided urine represents the urethral sample, the midstream urine represents the bladder sample, and the first 10 mL voided immediately after prostatic massage represents the prostate sample. When the bladder sample is sterile or nearly so, bacterial prostatitis is diagnosed if the bacterial count in the prostate sample is at least one logarithm greater than that in the urethral sample.」

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順便附上Dipro 12版課本的圖：

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(D)

急性前列腺炎治療：2~4週

慢性前列腺炎治療：4~6週

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Applied 12版課本原文：「The duration of antibiotic therapy in acute prostatitis is 2 to 4 weeks, depending on the severity of the infection and rate of response to treatment. Chronic prostatitis is usually treated for 4 to 6 weeks, although longer courses may be required in the presence of prostate stones or other types of genitourinary pathology, and long-term suppressive therapy is sometimes used for patients with a history of rapid and/or multiple recurrences.」

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(C) 我也有意見的選項

課本都沒有直接明寫出藥物用在前列腺炎的劑量，只有統整一張藥物用在UTI的劑量表

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雖然上表是有寫Levofloxacin 250 mg 或500 mg QD

但是仿單在「慢性前列腺炎」是寫說500 mg QD

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我個人對於Levofloxacin的劑量很有意見, 沒有提到腎功能異常與否則劑量多半為500-750mg QD (Ref: UpToDate, Sanford guide)

關於FQs的頻次快速簡單記法

名字有「r」的BID：ciprofloxacin

其他都QD：levofloxacin

ref:前人口訣

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祝大家考試順利