Antibiotics are needed for inflammation of the prostate. If the disease is not treated, the likelihood of impotence, infertility, sclerosis, adenoma, and glandular abscess increases.
When and why antibiotics are needed for prostatitis
The bacterial form of pathology is found in approximately 12-18% of patients. An acute process is diagnosed in 5-9 men out of 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 the functions of the gland, improve urine flow and blood circulation.
The 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 know which antibiotic is the best. Bacterial inflammation in prostate tissue is caused by many disease-causing organisms, so a drug may be effective against one type of germ and not be useful 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 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, a bacteriological inoculation or a more informative method of DNA diagnosis is carried out - PCR (polymerase chain reaction).
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 gland 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 dosages and combinations;
- the ability to combine the drug with other drugs and methods of therapy;
- previous antibiotic treatment (onset and duration);
Groups of effective antibiotics and prescription characteristics
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 in 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 rashes;
- Itch;
- 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 tissue of the prostate gland, 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.
The drugs are considered of low toxicity; only individual intolerance to cephalosporins is called absolute contraindications.
If the course of the disease is severe, or you have recently been treated with antibiotics, they resort to the use of cephalosporins in combination with aminoglycosides.
Fluoroquinolones
They have a strong and long-term 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 for the treatment of a chronic process, except in cases where pathogens are suspected of being resistant to them. Its effectiveness in suppressing microorganisms is 65 to 90%.
Due to the long-lasting effect, fluoroquinolones are taken 1-2 times a day. Not prescribed for epilepsy, adolescent children under 15-16 years. Doses are adjusted in men with heart and kidney pathologies, patients receiving antidepressants.
The drugs are generally well tolerated. In rare cases, observe:
- rash;
- Itch;
- swelling of the vocal cords;
- Stomach ache;
- nausea;
- Diarrhea;
- insomnia;
- nervousness;
- photosensitization (sensitivity of the skin to the sun) under ultraviolet radiation.
Macrolides
The active principles accumulate in the affected prostate tissue. Macrolides are often prescribed acutely without complications and in the chronic course of the disease. High macrolide activity is seen in chlamydial prostatitis. However, they do not suppress the typical pathogen of the pathology - Escherichia coli and atypical microorganisms - mycobacteria, clostridia, enterococci.
Adverse reactions are rare, more often in patients with intolerance to this group of antibiotics, severe liver or kidney damage. They rarely occur:
- nausea;
- acidity;
- 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 rapidly 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 low accumulation (accumulation) in the prostate tissue. The body slowly gets used to gentamicin.
The remedy is contraindicated for:
- increased reaction to aminoglycosides;
- severe kidney dysfunction;
- Do not lie;
- parkinsonism;
- hearing impairment;
- dehydration.
Nausea, anemia, epilepsy, drowsiness, and impaired kidney function can occur.
Ansamycins
They have a wide spectrum 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 concentration in the tissues of the organ. Fecal enterococcus does not respond to treatment with tetracyclines.
They are now rarely prescribed due to their high toxicity, the ability to penetrate sperm and affect male reproductive cells. After the end of therapy, 3-4 months should pass before conception.
Adverse reactions: intestinal disorders, nausea, impaired liver function, allergic reactions, candidiasis.
Combined treatment
If prostatitis is caused by Trichomonas, ureaplasma, mycobacteria, a combination treatment regimen is being developed. Provides a combination of several groups of drugs.
Local treatment
Suppositories are prescribed for bacterial inflammation in the prostate to increase the effectiveness of treatment. Administration of antibiotic suppositories has the following advantages:
- rapid penetration into the gland tissue 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 penetrating the general bloodstream;
- low dose;
- small number of contraindications, easy application.
Indications for the use of antibacterial suppositories are similar to those for other medicinal forms: tablets, capsules, injections.
Suppositories contain fewer antibiotics than tablets and solutions, so they are used for longer.
List of commonly prescribed suppositories:
- Suppositories with framycetin (aminoglycosides).
- Suppositories with erythromycin (macrolides).
- Chloramphenicol suppositories (active ingredient - chloramphenicol).
- Rifampin suppositories are effective, rapidly penetrating the gland and killing most germs. In case of tuberculous prostatitis, treatment lasts 6 to 9 weeks.
General principles of application
At home, you need to follow the principles of using antimicrobial drugs.
- Accurately adhere to the prescribed doses, adhere to the regimen and therapy 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, the acute process will quickly become chronic. The remaining microorganisms will continue to act "underground" and will 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 should go to the doctor's appointment.
The treatment regimen for prostatitis is developed taking into account many factors. An antibiotic that works for one patient may not work for another.