Antibiotics for inflammation of the prostate gland are necessary. If the disease is left untreated, the likelihood of impotence, infertility, sclerosis, adenoma and gland abscess increases.
When and why antibiotics are needed for prostatitis
The bacterial form of pathology is found in about 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 sluggish 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, 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 tell which antibiotic is the best. Bacterial inflammation in prostatic tissue is caused by many disease-causing organisms, so one drug may be effective against one type of germ and not 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 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 DNA diagnostics is carried out - PCR (polymerase chain reaction).
When choosing a drug, take into account:
- 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;
- doses and combinations of drugs;
- the ability to combine the drug with other drugs and therapy methods;
- previous antibiotic treatment (onset and duration);
Groups of effective antibiotics and prescription features
For an 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 more effective when combined with clavulanic acid.
This group of antibiotics works better in an acute uncomplicated process and rare exacerbations of a chronic form of the disease, if typical pathogens of the pathology are identified. They do not suppress chlamydia, mycoplasma, 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 tissue of the prostate gland, 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 intolerance to cephalosporins is referred to as absolute contraindications.
If the course of the disease is severe, or has 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 the prostatic tissue, therefore, are considered first-line drugs for the treatment of a chronic process, except in cases where pathogens are suspected of being resistant to them. Their effectiveness in suppressing microorganisms is 65 - 90%.
Due to the prolonged effect, fluoroquinolones are taken 1-2 times a day. Not prescribed for epilepsy, adolescent boys under 15 - 16 years old. Doses are adjusted in men with cardiac, renal pathologies, patients receiving antidepressants.
The drugs are usually well tolerated. In rare cases, observe:
- rash;
- 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 activity of macrolides is 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 often in patients with intolerance to this group of antibiotics, serious liver or kidney damage. Rarely occur:
- nausea;
- heartburn;
- dysbiosis;
- hives;
- 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 insensitive to other groups of antibiotics.
In the chronic course of bacterial prostatitis, aminoglycosides are not prescribed due to low accumulation (accumulation) in the prostatic tissue. The body gets used to Gentamicin slowly.
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 renal function may occur.
Ansamycins
They have a wide spectrum of action against microbes. The drugs are chosen if 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 concentration in the tissues of the organ. Fecal enterococcus does not respond to tetracyclines treatment.
Now they are rarely prescribed because of their high toxicity, the ability to penetrate the sperm and affect the male reproductive cells. After the end of therapy, 3-4 months should pass before conception.
Adverse reactions: bowel disorders, 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 for a combination of several groups of drugs.
Local treatment
Suppositories for bacterial inflammation in the prostate are prescribed to increase the effectiveness of treatment. 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 penetrating into the general bloodstream;
- low dosages;
- 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 less antibiotic than tablets and solutions, so the course of their use is longer.
List of commonly prescribed suppositories:
- Suppositories with framycetin (aminoglycosides).
- Suppositories with erythromycin (macrolides).
- Chloramphenicol suppositories (active ingredient - chloramphenicol).
- Suppositories with rifampicin are effective, which quickly penetrates the gland and destroys most microbes. In case of tuberculous prostatitis, treatment lasts 6-9 weeks.
General principles of application
At home, you need to follow the principles of using antimicrobial drugs.
- Accurately adhere to the prescribed dosages, adhere to the regimen and the therapy 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 prostatic tissue, then the acute process will quickly turn into a chronic one. The remaining microorganisms will continue to act "underground" and develop antibiotic resistance.
- The standard duration of treatment is at least 8-12 days in the acute period, and up to 6 weeks in the chronic one.
- If in the acute phase, after 3 days of treatment, the pain and temperature do not decrease, you need to come 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.