Antibiotics are necessary for inflammation of the prostate. If left untreated, the likelihood of impotence, infertility, sclerosis, adenomas, and gland abscesses increases.
When and why antibiotics are needed for prostatitis
The bacterial form of the pathology is found in about 12-18% of patients. The acute process is diagnosed in 5-9 men out of 100 aged 22-45 years, chronic slow flow - in 8-11% of patients.
The main task of antibiotic treatment is to suppress the activity of pathogenic microbes. They relieve inflammation, pain, normalize glandular functions, improve urine flow and blood circulation.
The diagnosis is based on:
- laboratory tests confirming the presence of bacteria in semen, urine, prostate secretions;
- characteristic symptoms;
- signs of inflammation, which are reflected in changes in the composition of urine and blood.
Important factors when choosing antibiotics
It is impossible to say which antibiotic is the best. Bacterial inflammation in prostate tissue is caused by many disease-causing organisms, so one drug may be effective against one type of germ rather than beneficial against another.
Only an antibiotic, selected taking into account certain factors, will have a positive therapeutic effect:
- type of pathogen (determined by bacteriological analysis of microflora);
- sensitivity of identified bacteria to specific antibiotics.
Causes of bacterial prostatitis can be:
- typical gram-negative pathogens Escherichia coli (Escherichia coli) and Pseudomonas aeruginosa (Pseudomonas aeruginosa) - 55-80%;
- 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.
For precise identification of pathogens, bacteriological inoculation or a more informative method of DNA diagnostics - PCR (polymerase chain reaction) is performed.
When choosing a drug, consider:
- spectrum of action - the number and types of pathogens that a particular antibiotic can control;
- the ability of the drug to accumulate in the prostate and maintain the desired concentration;
- long-lasting antibacterial action;
- side effects and contraindications;
- method of drug administration;
- path and speed of excretion from the organism;
- dosages 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 characteristics
In order for an antibiotic to penetrate the gland easily, it must be fat-soluble, bind poorly to blood proteins, and be active in an alkaline environment.
Aminopenicillins
Today, preference is given to protected penicillins, resistant to the destructive action of the enzyme - b-lactamase, which is secreted by the coca flora. Penicillins are more effective in combination with clavulanic acid.
This group of antibiotics works better in the acute uncomplicated process and rare exacerbations of the chronic form of the disease, if typical pathogens are identified. They do not suppress chlamydia, mycoplasma, enterobacteria.
Possible side effects:
- nausea;
- diarrhea;
- allergic rash;
- itching;
- people prone to drug allergies may experience allergic shock.
Cephalosporins
They act on many pathogens, but not for long. Effective in acute prostatitis. They accumulate poorly in the prostate tissue, so in the chronic process they are briefly used as a "shock" group of antibiotic action.
Staphylococcal flora and clostridia are resistant to cephalosporins.
The drugs are considered to be of low toxicity, and the absolute contraindication is considered only individual intolerance to cephalosporins.
If the course of the disease is severe, or has recently been treated with antibiotics, the use of cephalosporins in combination with aminoglycosides is resorted to.
Fluoroquinolones
They have a strong and long-lasting effect on most typical and atypical bacteria, including Pseudomonas aeruginosa (Pseudomonas aeruginosa), mycoplasma, chlamydia. Fluoroquinolones create a high concentration in prostate tissue, so they are considered first-line drugs to treat the chronic process, except when pathogens are suspected to be resistant to them. Their efficiency in the control of microorganisms is 65-90%.
Due to its prolonged effect, fluoroquinolones are taken 1-2 times a day. Not prescribed for epilepsy, adolescents younger than 15 - 16 years. Doses are adjusted for men with heart and kidney pathologies, patients who receive antidepressants.
Medications are usually well tolerated. In rare cases, pay attention to:
- rash;
- itching;
- swelling of the vocal cords;
- abdominal pain;
- nausea;
- diarrhea;
- insomnia;
- nervousness;
- photosensitization (skin sensitivity to the sun) under UV radiation.
Macrolides
The active substances accumulate in the affected prostate tissue. Macrolides are often prescribed in an acute form without complications and in the chronic course of the disease. High macrolide activity has been 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.
Adverse reactions are rare, more common in patients with intolerance to this group of antibiotics, severe liver or kidney damage. Rarely occur:
- 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 quickly suppresses the activity of most types of pathogens, including atypical forms, fungi and mutated microbes that are insensitive to other groups of antibiotics.
In the chronic course of bacterial prostatitis, aminoglycosides are not prescribed due to the small accumulation (accumulation) in the prostate tissue. The body slowly gets used to gentamicin.
The drug is contraindicated for:
- increased reaction to aminoglycosides;
- severe renal dysfunction;
- Do not lie;
- parkinsonism;
- Hearing damage;
- dehydration.
Nausea, anemia, epilepsy, drowsiness and impaired renal function may occur.
Ansamycins
They have a wide range of action against microbes. Drugs are chosen if the prostatitis is severe, with tuberculous mycobacteria (Koch's bacillus) - Mycobacterium tuberculosis.
Tetracyclines
They have a high natural activity against chlamydial and mycoplasma prostatitis. They accumulate in high concentrations in the tissues of organs. Fecal enterococci do not respond to tetracycline therapy.
They are now rarely prescribed because of their high toxicity, ability to penetrate sperm, and impact on male reproductive cells. After the end of therapy, 3-4 months should pass before conception.
Side effects: intestinal disorders, nausea, deterioration of liver function, allergic reactions, candidiasis.
Combined treatment
If prostatitis is caused by trichomonas, ureaplasma, mycobacteria, a combined treatment regimen is developed. It envisages a combination of several groups of drugs.
Local treatment
To increase the effectiveness of treatment, suppositories are prescribed for bacterial inflammation of the prostate. The use of antibiotic suppositories has the following advantages:
- rapid penetration of glandular tissue through the intestinal wall;
- maximum accumulation of the drug in the gland;
- minimal side effects, because the drug is concentrated in the tissues, with almost no penetration into the general bloodstream;
- low doses;
- small number of contraindications, easy application.
Indications for the use of antibacterial suppositories are similar to those for other forms of drugs - tablets, capsules, injections.
Suppositories contain fewer antibiotics than tablets and solutions, so the course of their use is longer.
List of most commonly prescribed suppositories:
- Suppositories with framicetin (aminoglycosides).
- Suppositories with erythromycin (macrolides).
- Chloramphenicol suppositories (active ingredient - chloramphenicol).
- Suppositories with rifampicin are effective, which quickly penetrate the gland and destroy most microbes. In the case of tuberculous prostatitis, the treatment lasts 6-9 weeks.
General principles of application
At home you need to follow the principles of using antimicrobial drugs.
- Adhere to the prescribed doses exactly, adhere to the regimen and treatment regimen, if a combination of drugs is prescribed.
- The course of therapy must be completely completed. If you interrupt the flow of medicinal substances into the prostate tissue, then the acute process will quickly turn into a chronic one. 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 decrease, it is necessary to come for an examination.
The treatment regimen for prostatitis develops taking into account many factors. An antibiotic that works for one patient may not work for another.