Antibiotics are needed for prostatitis. If left untreated, the disease increases the likelihood of impotence, infertility, sclerosis, adenoma, and glandular abscess.
When and why are antibiotics needed for prostatitis
The bacterial form of the pathology is found in about 12-18% of patients. Acute process is diagnosed in 5-9 out of 100 men aged 22-45 years, chronic sluggish course - in 8-11% of patients.
The main task of antibiotic treatment is to suppress the activity of pathogenic microbes. They relieve inflammation, pain, normalize gland function, improve urine flow and blood circulation.
The diagnosis is based on:
- laboratory tests that confirm the presence of bacteria in semen, urine, prostate secretions;
- characteristic symptoms;
- signs of inflammation reflected in changes in the composition of urine and blood.
Important considerations when selecting an antibiotic
It is impossible to say which antibiotic is best. Bacterial inflammation in prostate tissue is caused by a number of disease-causing organisms, so one drug may be effective against one type of germ and not useful against another.
An antibiotic selected with only certain factors in mind has a positive therapeutic effect:
- the type of pathogen (determined by bacteriological analysis of the microflora);
- susceptibility of identified bacteria to specific antibiotics.
The pathogens of bacterial prostatitis may include:
- typical gram-negative pathogens Escherichia coli (Escherichia coli) and Pseudomonas aeruginosa (Pseudomonas aeruginosa) - 55-80%;
- enterobacteriaceae (Enterobacteriaceae) - 10-30%;
- fecal enterococci (Enterococcus faecalis) - 5-10%;
- atypical pathogens - chlamydia (Chlamydia) - 36%, Trichomonas - 11%;
- ureaplasma (Ureaplasma) and mycobacteria (Musoplasma) - 20%.
- rarely detected pathogens - gonococci, fungi, Proteus, Klebsiella, gram-positive bacteria - staphylococci and streptococci.
Bacteriological vaccination or a more informative DNA diagnostic method - PCR (polymerase chain reaction) - is performed to accurately identify the pathogen.
When choosing a medicine, consider:
- spectrum of action - the number and types of pathogens that can be suppressed by a given antibiotic;
- the ability of the drug to accumulate in the prostate gland and maintain the desired concentration;
- long-term antibacterial effect;
- side effects and contraindications;
- the method of administration of the drug;
- the manner and rate of excretion from the organism;
- doses and combinations of drugs;
- the ability to combine the drug with other drugs and therapeutic methods;
- previous antibiotic treatment (onset and duration);
Groups of effective antibiotics and prescription properties
For an antibiotic to easily penetrate the gland, it must be fat-soluble, poorly bound to blood proteins, and active in an alkaline environment.
Aminopenicillins
Today, protected penicillins are preferred, which resist the destructive effects of enzymes secreted by the coconut flora, β-lactamases. Penicillins are more effective in combination with clavulanic acid.
This group of antibiotics works better in an acute, uncomplicated process and in rare exacerbations of the chronic form of the disease if the typical pathogens of the pathology are identified. They do not suppress chlamydia, mycoplasma, enterobacteria.
Possible side effects:
- nausea;
- diarrhea;
- allergic rashes;
- itchy;
- people who are prone to drug allergies may get an allergic shock.
Cephalosporins
They act on many pathogens, but not for long. Effective in acute prostatitis. They accumulate poorly in prostate tissue, so they are used for a short time in a chronic process as a "shock" group of antibiotic action.
The staphylococcus flora and clostridia are resistant to cephalosporins.
The drugs are considered to be of low toxicity and only individual intolerance to cephalosporins is considered an absolute contraindication.
If the course of the disease is severe or has recently been treated with antibiotics, cephalosporins are used in combination with aminoglycosides.
Fluoroquinolones
They have a strong and long-lasting effect on most typical and atypical bacteria, including Pseudomonas Aeruginosa (Pseudomonas aeruginosa), mycoplasma, chlamydia. Fluoroquinolones produce high concentrations in prostate tissue and are therefore considered first-line drugs for the treatment of chronic processes, except when pathogens are suspected to be resistant to them. Their effectiveness in suppressing microorganisms is 65-90%.
Due to the prolonged effect, fluoroquinolones should be taken 1-2 times daily. It is not prescribed to adolescent boys under 15-16 years of age with epilepsy. Doses are adjusted in men with heart and kidney disease and in patients taking antidepressants.
Medications are generally well tolerated. In rare cases, consider:
- rash;
- itchy;
- swelling of the vocal cords;
- abdominal pain;
- nausea;
- diarrhea;
- insomnia;
- nervousness;
- photosensitivity (sensitivity of the skin to the sun) when exposed to UV radiation.
Macrolides
The active substances accumulate in the affected prostate tissue. Macrolides are often prescribed in acute form without complications and in the chronic course of the disease. High activity of macrolides is observed in prostatitis caused by chlamydia. However, they do not suppress the typical pathogen of the pathology - Escherichia coli and atypical microorganisms - mycobacteria, clostridia, enterococci.
Side effects are rare, more common in patients with intolerance to this type of antibiotic, severe liver or kidney damage. It happens rarely:
- nausea;
- heartburn;
- dysbiosis;
- hives;
- diarrhea.
Aminoglycosides
Gentamicin has many contraindications and often causes side effects. It is prescribed to patients with an acute course of the disease. The drug rapidly suppresses the activity of most types of pathogens, including atypical forms, fungi, and mutant microbes that are insensitive to other classes of antibiotics.
In the chronic course of bacterial prostatitis, aminoglycosides are not prescribed due to low accumulation (accumulation) in prostate tissue. The body is slowly getting used to Gentamicin.
The drug is contraindicated in:
- increased reaction to aminoglycosides;
- severe renal insufficiency;
- Do not lie;
- parkinsonism;
- Hearing impairment;
- dehydration.
Nausea, anemia, epilepsy, drowsiness and impaired kidney function may occur.
ansamycins
They have a broad spectrum of activity against microbes. Drugs are selected when the inflammation of the prostate is severe, tuberculous mycobacterium (Kochbacillus) - mycobacterium tuberculosis.
Tetracyclines
They have high natural activity against chlamydia and mycoplasma prostatitis. They accumulate in high concentrations in the tissues of the organ. Fecal enterococcus does not respond to tetracycline treatment.
They are rarely prescribed today because of their high toxicity, penetration into sperm, and efficacy on male reproductive cells. After completion of therapy, 3-4 months should elapse before conception.
Side effects: intestinal disorders, nausea, deterioration of liver function, allergic reactions, candidiasis.
Combination therapy
If prostatitis is caused by Trichomonas, ureaplasma, mycobacteria, a combination regimen will be developed. It prescribes a combination of several groups of drugs.
Local treatment
Suppositories are prescribed for bacterial inflammation of the prostate to increase the effectiveness of the treatment. The administration of antibiotic suppositories has the following advantages:
- rapid penetration of glandular tissue through the intestinal wall;
- maximal accumulation of the drug in the gland;
- minimal side effect as the drug is concentrated in the tissues, almost without penetrating the general bloodstream;
- low doses;
- small number of contraindications, easy application.
The indications for the use of antibacterial suppositories are similar to other dosage forms - tablets, capsules, injections.
Suppositories contain less antibiotics than tablets and solutions, so they last longer.
List of commonly prescribed suppositories:
- Suppositories with framycetin (aminoglycosides).
- Suppositories with erythromycin (macrolides).
- Chloramphenicol suppositories (active substance - chloramphenicol).
- Suppositories containing rifampicin are effective in rapidly penetrating the gland and killing most microbes. In case of tuberculous prostatitis, the treatment lasts for 6-9 weeks.
General principles of application
You should adhere to the principles of using antimicrobials at home.
- Follow the prescribed doses exactly, follow the treatment regimen and the therapeutic regimen when prescribing a combination of drugs.
- The therapeutic course must be completed completely. If you interrupt the flow of drugs into the prostate tissue, the acute process quickly becomes chronic. The remaining microorganisms will continue to function "underground" and develop antibiotic resistance.
- The standard duration of treatment is a minimum of 8-12 days in the acute period and a maximum of 6 weeks in the chronic period.
- If the pain and temperature do not decrease in the acute phase after 3 days of treatment, you should see a doctor.
Treatment regimens for prostatitis are designed with a number of factors in mind. An antibiotic that is effective in one patient may not be effective in another.