Antibiotics for prostate inflammation are needed. If the disease is not treated, it increases the likelihood of impotence, infertility, sclerosis, adenoma and gland abscess.
When and why antibiotics are needed for prostatitis
The bacterial form of the pathology is found in about 12-18% of patients. An acute process is diagnosed in 5-9 men in 100 at the age of 22-45 years, a chronic slow 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 functions, improve urinary flow and blood circulation.
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 factors when choosing an antibiotic
It is impossible to say which antibiotic is best. Bacterial inflammation in prostate tissue is caused by many disease-causing organisms; therefore, a drug may be effective against one type of germ and not useful against another.
Only one antibiotic, selected taking into account certain factors, will have a positive therapeutic effect:
- type of pathogen (determined by bacteriological analysis of the microflora);
- the sensitivity of identified bacteria to specific antibiotics.
The causative agents of bacterial prostatitis can be:
- 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.
To accurately identify the pathogen, bacteriological inoculation or a more informative DNA diagnostic method - PCR (Polymerase Chain Reaction) is performed.
When choosing a drug, consider:
- spectrum of action - the number and types of pathogens that a specific antibiotic can suppress;
- the ability of a medicinal substance to accumulate in the prostate and maintain the desired concentration;
- long-term antibacterial effect;
- adverse reactions and contraindications;
- method of drug administration;
- route and rate of excretion from the body;
- drug doses and combinations;
- the ability to combine the drug with other drugs and therapy methods;
- previous antibiotic treatment (onset and duration);
Effective Antibiotic Groups and Prescribing Resources
In order for the antibiotic to easily penetrate the gland, it must be fat-soluble, weakly bind to blood proteins, and be active in an alkaline environment.
Aminopenicillins
Today, preference is given to protected penicillins, resistant to the destructive action of enzymes - b-lactamases, secreted by the coccal flora. Penicillins are most effective when combined with clavulanic acid.
This group of antibiotics works best in an uncomplicated acute process and rare exacerbations of a chronic form of the disease, if the typical pathogens of the pathology are identified. They do not suppress chlamydia, mycoplasma, enterobacteria.
Possible side reactions:
- nausea;
- diarrhea;
- allergic rash;
- itch;
- people prone to drug allergies may experience allergic shock.
Cephalosporins
They act on many pathogens, but not for long. Effective for acute prostatitis. They accumulate little in prostate tissue, therefore, in a chronic process, they are used as a "shock" group of antibiotic action for a short period of time.
Staphylococcal flora and clostridia are resistant to cephalosporins.
Drugs are considered to have low toxicity, only individual intolerance to cephalosporins is referred to as absolute contraindications.
If the course of the disease is severe, or if it has recently been treated with antibiotics, they resort to using cephalosporins in combination with aminoglycosides.
Fluoroquinolones
They have a strong, long-term effect on most typical and atypical bacteria, including Pseudomonas aeruginosa (Pseudomonas aeruginosa), mycoplasma, chlamydia. Fluoroquinolones create high concentrations in prostate tissue, therefore, they are considered first-line drugs for the treatment of a chronic process, except in cases where resistance to pathogens is suspected. Its effectiveness in suppressing microorganisms is 65 to 90%.
Due to their long-lasting effect, fluoroquinolones are taken 1 to 2 times a day. Not prescribed for epilepsy, adolescent boys under 15 - 16 years of age. Doses are adjusted for men with heart and kidney disease and patients receiving antidepressants.
Medications are generally well tolerated. In rare cases, please note:
- skin irritation;
- itch;
- swelling of the vocal cords;
- stomachache;
- nausea;
- diarrhea;
- insomnia;
- nervousness;
- photosensitization (skin sensitivity to the sun) under UV irradiation.
Macrolides
Active substances accumulate in the affected tissue of the prostate. Macrolides are often prescribed in the acute, uncomplicated and chronic course of the disease. High macrolide activity is seen in prostatitis caused by chlamydia. However, they do not suppress the typical pathogen of the pathology - Escherichia coli and atypical microorganisms - mycobacteria, clostridia, enterococci.
Adverse reactions are rare, more frequently in patients with intolerance to this group of antibiotics, with severe liver or kidney damage. Rarely occur:
- nausea;
- heartburn;
- dysbiosis;
- urticaria;
- diarrhea.
Aminoglycosides
Gentamicin has many contraindications and often causes side reactions. It is prescribed for 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 groups of antibiotics.
In the chronic course of bacterial prostatitis, aminoglycosides are not prescribed because of their low accumulation (build-up) in the prostate tissue. The body slowly gets used to gentamicin.
The drug is contraindicated for:
- increased reaction to aminoglycosides;
- severe kidney dysfunction;
- Do not lie;
- parkinsonism;
- hearing deficiency;
- dehydration.
Nausea, anemia, epilepsy, drowsiness and kidney failure may occur.
Ansamycins
They have a broad spectrum of action against microbes. Drugs are chosen if the prostatitis is severe, with Mycobacterium tuberculous (Koch's bacillus) - Mycobacterium tuberculosis.
tetracyclines
They have high natural activity against chlamydial and mycoplasma prostatitis. They accumulate in high concentration in organ tissues. Fecal enterococci does not respond to treatment with tetracyclines.
Now, they are rarely prescribed because of their high toxicity, ability to penetrate sperm and affect male reproductive cells. After the end of therapy, 3-4 months should pass before conception.
Adverse reactions: intestinal disturbances, nausea, deterioration of liver function, allergic reactions, candidiasis.
Combined treatment
If prostatitis is caused by Trichomonas, ureaplasma, mycobacteria, a combined treatment regimen is being developed. It provides a combination of various drug groups.
local treatment
Suppositories for bacterial inflammation in the prostate are prescribed to increase the effectiveness of the treatment. The administration of antibiotic suppositories has the following advantages:
- rapid penetration into gland tissue through the intestinal wall;
- maximum accumulation of the medicinal substance in the gland;
- a minimum of side reactions, as the drug concentrates in tissues, barely entering the general bloodstream;
- low dosages;
- small number of contraindications, easy application.
The indications for the use of antibacterial suppositories are similar to other medicinal forms - pills, capsules, injections.
Suppositories contain fewer antibiotics than pills and solutions, so the course of their use is longer.
List of commonly prescribed suppositories:
- Suppositories with framicetin (aminoglycosides).
- Erythromycin suppositories (macrolides).
- Chloramphenicol suppositories (active ingredient - chloramphenicol).
- Rifampicin suppositories are effective as they quickly penetrate the gland and destroy most microbes. In the case of tuberculous prostatitis, treatment lasts from 6 to 9 weeks.
General application principles
At home, you need to follow the principles of using antimicrobial drugs.
- Accurately follow prescribed dosages, regimen and therapy regimen if a combination of medications is prescribed.
- The course of therapy must be completed completely. If you stop the flow of medicinal substances to the prostate tissue, the acute process will quickly become chronic. The remaining microorganisms will continue to act "underground" and develop resistance to antibiotics.
- The standard duration of treatment is at least 8-12 days in the acute period and up to 6 weeks in the chronic period.
- If in the acute phase, after 3 days of treatment, the pain and temperature do not go down, it is necessary to go to the doctor.
The treatment regimen for prostatitis is designed with many factors in mind. An antibiotic that works for one patient may not work for another.