Antibiotics for inflammation of the prostate are needed. If the disease is not treated, the risk of impotence, infertility, sclerosis, adenoma and abscess of the glands increases.
When and why are antibiotics needed for prostatitis
The bacterial form of the pathology is found in approximately 12 to 18% of patients. An acute process is diagnosed in 5-9 in 100 men by 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 the functions of the gland, improve urine flow and blood circulation.
The diagnosis is based on:
- laboratory tests confirming the presence of bacteria in semen, urine, secretions from the prostate;
- characteristic symptoms;
- signs of inflammation, reflected by changes in the composition of urine and blood.
Important factors when choosing an antibiotic
It is impossible to say which antibiotic is the best. Bacterial inflammation in prostate tissue is caused by many pathogenic organisms, so a drug may be effective against one type of germ and not helpful against another.
Only an antibiotic, chosen taking into account certain factors, will have a positive therapeutic effect:
- type of pathogen (determined by bacteriological analysis of the microflora);
- the sensitivity of the 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 method of diagnosis of DNA - 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;
- side effects and contraindications;
- method of drug administration;
- route and rate of excretion from the body;
- doses and combinations of drugs;
- the ability to combine the drug with other drugs and therapeutic methods;
- previous antibiotic treatment (start and duration);
Groups of effective antibiotics and prescribing characteristics
In order for the antibiotic to easily enter 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 in rare exacerbations of a chronic form of the disease, if pathogens typical of the pathology are identified. They do not suppress chlamydia, mycoplasmas, enterobacteria.
Possible side reactions:
- nausea;
- diarrhea;
- allergic rashes;
- itching;
- people with a tendency to drug allergies may experience allergic shock.
Cephalosporins
They act on many pathogens, but not for long. Effective for acute prostatitis. They accumulate poorly in the tissues of the prostate. Therefore, in a chronic process, they are used as a "shock" group of antibiotic action for a short time.
Staphylococcal flora and clostridia are resistant to cephalosporins.
The drugs are considered to be of low toxicity, only individual cephalosporin intolerance is considered an absolute contraindication.
If the course of the disease is severe or has been recently treated with antibiotics, they resort to the use of cephalosporins in combination with aminoglycosides.
Fluoroquinolones
They have a powerful and long-term effect on most typical and atypical bacteria, including Pseudomonas Aeruginosa (Pseudomonas aeruginosa), mycoplasmas, chlamydia. Fluoroquinolones create a high concentration in prostate tissue and are therefore considered first-line drugs for the treatment of a chronic process, except in cases where the pathogens are suspected to be resistant to it. Their efficiency in suppressing microorganisms is 65-90%.
Due to the prolonged effect, fluoroquinolones are taken 1-2 times a day. Not prescribed for epilepsy, adolescents under 15 to 16 years old. The doses are adjusted in men with heart disease, kidney disease, patients receiving antidepressants.
The drugs are generally well tolerated. In rare cases, observe:
- eruption;
- itching;
- swelling of the vocal cords;
- stomach ache;
- nausea;
- diarrhea;
- insomnia;
- nervousness;
- photosensitization (sensitivity of the skin to the sun) under UV irradiation.
Macrolides
The active substances accumulate in the affected prostate tissue. Macrolides are often prescribed in the acute form without complications and in the chronic course of the disease. High macrolide activity is observed in prostatitis caused by chlamydia. However, they do not suppress the pathogen typical of the pathology - Escherichia coli and atypical microorganisms - mycobacteria, clostridia, enterococci.
Adverse effects are rare, more often in patients with intolerance to this group of antibiotics, severe liver or kidney damage. Rarely occur:
- nausea;
- stomach pains;
- dysbiosis;
- urticaria;
- diarrhea.
Aminoglycosides
Gentamicin has many contraindications and often causes side reactions. 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 unresponsive to other groups of antibiotics.
During the chronic course of bacterial prostatitis, aminoglycosides are not prescribed due to the low accumulation (accumulation) in the prostate tissue. The body slowly gets used to gentamicin.
The remedy is contraindicated for:
- increased reaction to aminoglycosides;
- severe renal dysfunction;
- Do not lie;
- parkinsonism;
- hearing impairment;
- dehydration.
Nausea, anemia, epilepsy, drowsiness and kidney failure may occur.
Ansamycins
They have a wide spectrum of action against microbes. Drugs are chosen if the prostatitis is severe, with tuberculous mycobacterium (Koch's bacillus) - mycobacterium tuberculosis.
Tetracyclines
They have high natural activity against chlamydial and mycoplasma prostatitis. They accumulate in high concentrations in the tissues of the organ. Fecal enterococcus does not respond to treatment with tetracyclines.
Now, they are rarely prescribed due to their high toxicity, ability to penetrate sperm and affect male reproductive cells. After the end of treatment, 3 to 4 months should pass before conception.
Adverse effects: 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 worked out. It provides for a combination of several groups of drugs.
Local treatment
Suppositories for bacterial inflammation of the prostate are prescribed to increase the effectiveness of treatment. The administration of antibiotic suppositories has the following advantages:
- rapid penetration into the tissue of the gland through the intestinal wall;
- maximum accumulation of the medicinal substance in the gland;
- a minimum of side reactions, since the drug is concentrated in the tissues, almost without entering the general bloodstream;
- low doses;
- small number of contraindications, easy application.
Indications for use of antibacterial suppositories are similar to other medicinal forms - tablets, capsules, injections.
Suppositories contain less antibiotics than tablets and solutions, therefore, their duration of use is longer.
List of commonly prescribed suppositories:
- Framycetin suppositories (aminoglycosides).
- Erythromycin suppositories (macrolides).
- Chloramphenicol suppositories (active ingredient - chloramphenicol).
- Suppositories containing rifampicin are effective, they quickly enter the gland and destroy most germs. In case of tuberculous prostatitis, the treatment lasts 6 to 9 weeks.
General principles of application
At home, you need to follow the principles of using antimicrobial drugs.
- Strictly observe the prescribed dosages, adhere to the therapeutic regimen and the therapeutic regimen, if a combination of drugs is prescribed.
- The course of therapy must be completed completely. If you interrupt the flow of medicinal substances into 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 decrease, you must go to the doctor.
The treatment regimen for prostatitis is developed taking into account many factors. An antibiotic that works for one patient may not work for another.