Antibiotics to treat inflammation of the prostate are necessary. If the disease is not treated, the possibility of impotence, infertility, sclerosis, adenomas and gland abscesses will increase.
When and why antibiotics are needed to treat prostatitis
Pathology in the form of bacteria is found in approximately 12-18% of patients. Among 100 men aged 22-45, 5-9 are diagnosed as an acute process, which is a chronic slow process-8-11% of patients.
The main task of antibiotic therapy is to inhibit the activity of pathogenic microorganisms. They relieve inflammation and pain, normalize gland function, and improve urine flow and blood circulation.
Diagnose based on:
- Laboratory tests confirmed the presence of bacteria in semen, urine, and prostate secretions;
- Characteristic symptoms;
- Signs of inflammation are reflected in changes in urine and blood components.
Important factors in choosing antibiotics
Unable to determine which antibiotic is best. Bacterial inflammation in prostate tissue is caused by many pathogenic organisms, so a drug may be effective against one type of bacteria but not against another.
Only antibiotics selected in consideration of certain factors will have a positive therapeutic effect:
- Type of pathogen (determined by bacteriological analysis of microbial community);
- The sensitivity of the identified bacteria to specific antibiotics.
The pathogens of bacterial prostatitis can be:
- Typical gram-negative pathogen Escherichia coli and Pseudomonas aeruginosa-55-80%;
- Enterobacteriaceae-10-30%;
- Enterococcus faecalis (Enterococcus faecalis)-5-10%;
- Atypical pathogens-Chlamydia-36%, Trichomonas-11%;
- Ureaplasma and Musoplasma-20%.
- Pathogens-Neisseria gonorrhoeae, fungi, Proteus, Klebsiella, Gram-positive bacteria-Staphylococcus and Streptococcus are rarely detected.
In order to accurately identify pathogens, PCR (polymerase chain reaction), a more informative method of bacterial inoculation or DNA diagnosis, was carried out.
When choosing drugs, please consider:
- Range of action-the number and type of pathogens that a specific antibiotic can inhibit;
- The ability of the drug to accumulate in the prostate and maintain the required concentration;
- Long-term antibacterial effect;
- Adverse reactions and contraindications;
- Method of administration;
- The route and rate of excretion from the body;
- Dosage and combination of drugs;
- The ability to combine drugs with other drugs and treatments;
- Previous antibiotic treatment (start and duration);
Effective antibiotic groups and prescription characteristics
In order for the antibiotic to easily penetrate the glands, it must be fat-soluble, have weak binding to blood proteins, and be active in an alkaline environment.
Ampicillin
Today, it is preferred to choose protected penicillins, which can resist the destructive action of β-lactamase, an enzyme secreted by the cocci flora. Penicillin is more effective when combined with clavulanic acid.
If the typical pathogens of pathology are identified, this group of antibiotics is more effective in acute simple processes and rare exacerbations of chronic diseases. They do not inhibit chlamydia, mycoplasma, and enterobacteria.
Possible side effects:
- nausea;
- diarrhea;
- Allergic rash;
- Itching;
- People who are prone to drug allergies may experience anaphylactic shock.
Cephalosporins
They act on many pathogens, but they do not last long. Effective for acute prostatitis. They accumulate very poorly in prostate tissue, therefore, in a chronic process, they are used as the "shock" group of antibiotic action in a short period of time.
Staphylococcus and Clostridium are resistant to cephalosporins.
These drugs are considered low-toxic; only individuals who are intolerant to cephalosporins are called absolute contraindications.
If the course of the disease is severe, or they have been treated with antibiotics recently, they will turn to the combination of cephalosporins and aminoglycosides.
Fluoroquinolones
They have strong long-term effects on most typical and atypical bacteria, including Pseudomonas aeruginosa (Pseudomonas aeruginosa), Mycoplasma, and Chlamydia. Fluoroquinolones have high concentrations in prostate tissue and are therefore considered to be the first-line drugs for the treatment of chronic processes, unless pathogens are suspected to be resistant to them. Their effectiveness in inhibiting microorganisms is 65-90%.
Due to the longer duration of action, fluoroquinolones are taken 1-2 times a day. Not suitable for epilepsy, adolescent boys under 15-16 years of age. Adjust the dosage in men with heart and kidney disease, and in patients receiving antidepressants.
These drugs are generally well tolerated. In rare cases, please note:
- rash;
- Itching;
- Swelling of the vocal cords;
- stomach ache;
- nausea;
- diarrhea;
- Insomnia;
- nervous;
- Photosensitivity under ultraviolet radiation (sensitivity of the skin to sunlight).
Macrolides
The active substance accumulates in the affected prostate tissue. Macrolides are usually prescribed in the acute form without complications and the chronic course of the disease. The high activity of macrolides is observed in prostatitis caused by chlamydia. However, they do not inhibit the typical pathogens of pathology-Escherichia coli and atypical microorganisms-Mycobacterium, Clostridium, Enterococcus.
Adverse reactions are rare, and are more common in patients who are intolerant to this group of antibiotics and have severe liver or kidney damage. Rarely happens:
- nausea;
- Heartburn;
- Ecological disorder
- measles;
- diarrhea.
Aminoglycosides
Gentamicin has many contraindications and often causes side effects. It is suitable for patients with an acute course of disease. The drug can quickly inhibit the activity of most types of pathogens, including atypical pathogens, fungi and mutant microorganisms that are not sensitive to other antibiotic groups.
In the chronic course of bacterial prostatitis, because the accumulation (accumulation) in the prostate tissue is low, no aminoglycoside drugs are prescribed. The body slowly gets used to gentamicin.
The drug is contraindicated in:
- Increased response to aminoglycosides;
- Severe renal insufficiency;
- Don't lie;
- Parkinson's disease;
- Hearing loss;
- Dehydrated.
There may be nausea, anemia, seizures, lethargy, and impaired kidney function.
Ansamycin
They have a wide range of effects on microorganisms. If prostatitis is severe, choose these drugs, including Mycobacterium tuberculosis (Kochertella)-Mycobacterium tuberculosis.
Tetracyclines
They have high natural activity against chlamydia and mycoplasma prostatitis. They accumulate in high concentrations in organ tissues. Enterococcus faecalis did not respond to tetracycline treatment.
They are rarely prescribed now because they are highly toxic, capable of penetrating sperm and affecting male germ cells. After treatment, it should take 3-4 months to get pregnant.
Adverse reactions: intestinal diseases, nausea, liver function deterioration, allergic reactions, candidiasis.
Comprehensive Treatment
If prostatitis is caused by trichomoniasis, ureaplasma, or mycobacteria, a combined treatment plan is being developed. It provides a combination of several groups of drugs.
Local treatment
Suppositories for the treatment of bacterial inflammation of the prostate are used to improve the therapeutic effect. The use of antibiotic suppositories has the following advantages:
- Quickly penetrate into the glandular tissue through the intestinal wall;
- Maximum accumulation of medicinal substances in the glands;
- Minimal side effects, because the drug is concentrated in the tissues and hardly penetrates into the general blood;
- Low dose
- Few contraindications and convenient application.
The indications for the use of antibacterial suppositories are similar to those for other medicinal forms-tablets, capsules, and injections.
Suppositories contain less antibiotics than tablets and solutions, so they take longer to use.
List of commonly used suppositories:
- Suppositories containing neomycin (aminoglycoside).
- Suppositories containing erythromycin (macrolide).
- Chloramphenicol suppositories (active ingredient-chloramphenicol).
- Suppositories containing rifampicin are effective, quickly penetrating the glands and destroying most microorganisms. In the case of tuberculous prostatitis, treatment lasts 6-9 weeks.
General principles applied
At home, you need to follow the principle of using antibacterial drugs.
- Accurately follow the prescribed dosage, follow the treatment plan and the treatment plan, if a combination medication is prescribed.
- The treatment process must be completely completed. If you interrupt the flow of medicine into the prostate tissue, the acute process will quickly turn into a chronic process. The remaining microorganisms will continue to operate "underground" and develop antibiotic resistance.
- The standard treatment time in the acute phase is at least 8-12 days, and the chronic phase is up to 6 weeks.
- If in the acute phase, after 3 days of treatment, the pain and temperature do not drop, you need to see a doctor.
The treatment plan for prostatitis is formulated in consideration of many factors. Antibiotics that are effective for one patient may not be effective for another patient.