Antibiotics for prostatitis are needed. If the disease is not treated, it increases the chances of impotence, infertility, sclerosis, adenomas, and gland abscesses.
When and Why to Take Antibiotics for Prostatitis?
The bacterial form of the disease occurs in about 12-18% of patients. The acute process is diagnosed in 5-9 out of 100 men aged 22-45 years, the chronic slow process - in 8-11% of patients.
The main task of antibiotic treatment is to stop the action of pathogenic bacteria. They reduce inflammation, pain, normalize gland functions, improve urine flow and blood circulation.
Diagnosis is based on:
- tests confirming 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 factors when choosing antibiotics
It is impossible to say which antibiotic is best. Bacterial inflammation in prostate tissue is caused by many disease-causing organisms, so one drug may be effective against one germ and not another.
Only an antibiotic selected taking into account certain factors has a positive therapeutic effect:
- type of pathogen (determined by bacteriological analysis of the microflora);
- The susceptibility of the bacteria is determined to the specific antibiotic.
The causative agents of bacterial prostatitis can be:
- typical gram-negative pathogens Escherichia coli (Escherichia coli) and Pseudomonas aeruginosa (Pseudomonas aeruginosa) - 55-80%;
- Enterobacteriaceae - 10-30%;
- 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.
To accurately identify the pathogen, a bacterial culture is carried out or a more informative DNA diagnostic method - PCR (polymerase chain reaction).
When choosing a drug, take into account:
- spectrum of action - the number and type of pathogens that a particular antibiotic can prevent;
- the ability of the drug to accumulate in the prostate gland and maintain the desired concentration;
- long-lasting antibacterial effect;
- adverse reactions and contraindications;
- method of drug administration;
- sugar and speed of excretion from the body;
- dosage and combination of drugs;
- the possibility of combining the drug with other drugs and therapeutic methods;
- previous antibiotic therapy (onset and duration);
Effective antibiotic classes and prescribing features
In order for an antibiotic to easily enter the gland, it must be fat soluble, weakly bound to blood proteins, and active in an alkaline environment.
Aminopenicillin
Today, preference is given to the use of protected penicillins, which are resistant to the destructive action of enzymes - b-lactamases, which are secreted by the coccyx flora. Penicillin is more effective when combined with clavulanic acid.
This class of antibiotics works better in an uncomplicated acute course and rare exacerbations of the chronic form, if typical pathogens are identified. They do not prevent chlamydia, mycoplasma, enterobacteria.
Possible side effects:
- nausea;
- diarrhea;
- allergic rash;
- itchy;
- People with a predisposition to drug allergies may experience allergic shock.
Cephalosporins
They act on many pathogens, but do not last long. Effective for acute prostatitis. They accumulate poorly in the tissue of the prostate gland, therefore, in a chronic process, they are used as a group of "shocking" antibiotic effects for a short time.
Staphylococci and clostridia resistant to cephalosporins.
The drug is considered to be of low toxicity, only individuals who are intolerant of cephalosporins are considered an absolute contraindication.
If their disease is severe, or they have recently been treated with antibiotics, they must use a cephalosporin in combination with an aminoglycoside.
Fluoroquinolones
They are potent and long-lasting against 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 agents for the treatment of chronic course, except in cases where the pathogen is suspected to be resistant. Their effectiveness in preventing microorganisms is 65 - 90%.
Because of its long-acting effect, fluoroquinolones are administered 1-2 times per day. Not prescribed for epilepsy, adolescent boys under 15 - 16 years old. The dose is adjusted in men with heart disease, kidney disease, patients taking antidepressants.
The drug is usually well tolerated. In some rare cases, observe:
- rash;
- itchy;
- swelling of the vocal cords;
- stomachache;
- nausea;
- diarrhea;
- insomnia;
- nervous;
- photosensitivity (sensitivity of the skin to the sun) to UV light.
Macrolides
The active substance accumulates in the affected prostate tissue. Macrolides are usually prescribed in an acute form without complications and in the chronic phase of the disease. High macrolide activity was observed in chlamydial prostatitis. However, they do not suppress the typical pathogens of the pathology - Escherichia coli and atypical microorganisms - mycobacteria, clostridia, enterococci.
Adverse reactions are rare, usually occurring in patients with intolerance to this class of antibiotics, with severe liver or kidney damage. Rarely happens:
- nausea;
- heartburn;
- biological disorders;
- hives;
- diarrhea.
Aminoglycosides
Gentamicin has many contraindications and often causes side effects. It is prescribed to patients who have an acute episode of the disease. The drug rapidly suppresses the activity of most pathogens, including atypical forms, fungi and mutated bacteria that are not sensitive 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 gets used to Gentamicin.
The remedy is contraindicated for:
- increased reactivity to aminoglycosides;
- severe renal dysfunction;
- Do not lie;
- Parkinson disease;
- deaf;
- dehydration.
Nausea, anemia, seizures, somnolence and impaired renal function may occur.
Ansamycins
They have a wide range of activity against bacteria. The drug is chosen if prostatitis is severe, with mycobacterium tuberculosis (Koch's bacillus) - mycobacterium tuberculosis.
Tetracyclines
They have high natural activity against chlamydia and mycoplasma prostatitis. They accumulate in high concentrations in the tissues of organs. Enterococcus in the stool did not respond to treatment with tetracyclines.
They are now less commonly prescribed because of their high toxicity, ability to penetrate sperm and affect male reproductive cells. After finishing treatment, 3-4 months will pass before conception.
Adverse reactions: intestinal disturbances, nausea, impaired liver function, allergic reactions, candidiasis.
Combination treatment
If prostatitis is caused by Trichomonas, ureaplasma, mycobacteria, a combined treatment regimen is being developed. It offers a combination of several classes of drugs.
Local treatment
Suppositories for bacterial prostatitis are prescribed to increase the effectiveness of treatment. Administration of antibiotic suppositories has the following advantages:
- rapid penetration into the tissue of the gland through the intestinal wall;
- maximum accumulation of the drug in the gland;
- minimal side effects, since the drug is concentrated in the tissues, almost does not penetrate into the blood as a whole;
- low dosage;
- small number of contraindications, easy to apply.
Indications for the use of antibacterial suppositories are similar to those for other forms of drugs - 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 (macrolid).
- Suppositories chloramphenicol (active ingredient - chloramphenicol).
- Suppositories with rifampicin are effective, quickly penetrate the gland and destroy most bacteria. In the case of tuberculous prostatitis, treatment lasts 6-9 weeks.
General principles of the application
At home, you need to adhere to the principles of using antibacterial drugs.
- Strictly adhere to the prescribed dosage, adhere to the regimen and treatment protocol, if there are indications for a combination of multiple drugs.
- The course of treatment must be completed completely. If you interrupt the flow of the drug into the prostate tissue, the acute process quickly turns into a chronic one. The remaining microorganisms will continue to work "underground" and develop antibiotic resistance.
- The standard duration of treatment is at least 8-12 days in the acute phase and up to 6 weeks in the chronic phase.
- If in the acute stage, after 3 days of treatment, the pain and temperature do not decrease, you need to see a doctor according to the appointment schedule.
Prostatitis treatment regimens are developed taking into account many factors. Antibiotics that work for one patient may not work for another.