Antibiotics for inflammation of the prostate gland are necessary. If the disease is not treated, the chances of impotence, infertility, sclerosis, adenomas and glandular abscesses increase.
When and why antibiotics are needed for prostatitis
This form of bacterial pathology is present in about 12-18% of patients. The acute process is diagnosed in 5-9 men out of 100 at the age of 22-45 years, the course of chronic damp-in 8-11% of patients.
The main task of antibiotic treatment is to inhibit the activity of pathogenic microbes. They relieve inflammation, pain, normalize glandular function, improve urine flow and blood circulation.
Diagnosis is based on:
- laboratory tests 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 antibiotics
It is impossible to know which antibiotic is best. Bacterial inflammation in prostate tissue is caused by many disease -causing organisms, so one drug may be effective against one type of germ and useless against another.
Only antibiotics, 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 identified bacteria to certain antibiotics.
The causative agent of bacterial prostatitis can be:
- common gram-negative pathogens Escherichia coli (Escherichia coli) and Pseudomonas aeruginosa (Pseudomonas aeruginosa)-55-80%;
- enterobacteriaceae (Enterobacteriaceae) - 10-30%;
- enterococci tahi (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 pathogens, bacteriological inoculation or a more informative DNA diagnostic method - PCR (polymerase chain reaction) is performed.
When choosing a drug, consider:
- spectrum of action - the number and type of pathogens that can be suppressed by a particular antibiotic;
- the ability of the drug substance to accumulate in the prostate gland and maintain the desired concentration;
- long -term antibacterial effect;
- adverse reactions and contraindications;
- methods of drug administration;
- the route and rate of excretion from the body;
- dosage and combination of drugs;
- the ability to combine drugs with other drugs and methods of therapy;
- previous antibiotic treatment (onset and duration);
Effective antibiotic group and prescription characteristics
In order for antibiotics to easily penetrate the glands, they must be fat -soluble, bind weakly to blood proteins, and active in an alkaline environment.
Aminopenicillin
Today, preference is given to protected penicillins, resistant to the damaging action of the enzyme - b -lactamase, which is secreted by the coccal flora. Penicillin is more effective when combined with clavulanic acid.
This group of antibiotics works best in uncomplicated acute processes and rare exacerbations in chronic disease forms, if typical pathological pathogens are identified. They do not block chlamydia, mycoplasma, enterobacteria.
Possible side effects:
- nausea;
- diarrhea;
- allergic rash;
- itching;
- people with a predisposition 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 gland, therefore, in the chronic process, they are used as a "shock" group of antibiotic action for a short time.
The staphylococcal and clostridia flora are resistant to cephalosporins.
Such drugs are considered to have low toxicity; only individual intolerance to cephalosporins is referred to as an absolute contraindication.
If the course of the disease is severe, or has recently been treated with antibiotics, they use cephalosporins in combination with aminoglycosides.
Fluoroquinolones
They have a strong and long -lasting effect on most typical and atypical bacteria, including Pseudomonas Aeruginosa (Pseudomonas aeruginosa), mycoplasma, chlamydia. Fluoroquinolones create high concentrations in prostate tissue, therefore, are considered first -line drugs for the treatment of chronic processes, except in cases where pathogens are suspected to be 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 the age of 15 - 16 years. The dose is adjusted in men with pathology of the heart, kidneys, patients receiving antidepressants.
Drugs are usually well tolerated. In rare cases, note:
- rash;
- itching;
- swelling of the vocal cords;
- stomachache;
- nausea;
- diarrhea;
- insomnia;
- nervous;
- photosensitization (sensitivity of the skin to the sun) under UV radiation.
Macrolide
The active substance accumulates 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 chlamydial -induced prostatitis. However, they do not block the typical pathological pathogens - Escherichia coli and atypical microorganisms - mycobacteria, clostridia, enterococci.
Adverse reactions are rare, more frequent in patients who are intolerant to this group of antibiotics, serious liver or kidney damage. Rare:
- nausea;
- heartburn;
- dysbiosis;
- itching;
- diarrhea.
Aminoglycoside
Gentamicin has many contraindications and often causes side effects. It is prescribed to patients with an acute course of the disease. The drug rapidly inhibits 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 prostate tissue. The body gets used to Gentamicin slowly.
This drug is contraindicated for:
- increased response to aminoglycosides;
- severe renal dysfunction;
- Do not lie;
- parkinsonism;
- hearing problem;
- dehydration.
Nausea, anemia, epilepsy, drowsiness, and impaired kidney function may occur.
Ansamycins
They have a broad spectrum of action against microbes. Drugs are selected if severe prostatitis, with mycobacterium tuberculosis (bacillus Koch) - mycobacterium tuberculosis.
Tetracyclines
They have high natural activity against chlamydial prostatitis and mycoplasma. They accumulate in high concentrations in organ tissues. Fecal enterococcus does not respond to tetracycline treatment.
Now they are rarely prescribed because of their high toxicity, ability to penetrate sperm and affect male reproductive cells. After the end of therapy, 3-4 months should pass before fertilization.
Adverse reactions: intestinal disorders, nausea, impaired liver function, allergic reactions, candidiasis.
Combined treatment
If prostatitis is caused by Trichomonas, ureaplasma, mycobacteria, a combined treatment regimen is being developed. It provides 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 glandular tissue through the intestinal wall;
- maximum accumulation of medicinal substances in the glands;
- at least a side effect, because the drug is concentrated in the tissues, almost without penetrating the general bloodstream;
- low dose;
- a small number of contraindications, easy application.
The indications for the use of antibacterial suppositories are similar to other forms of medicine - tablets, capsules, injections.
Suppositories contain fewer antibiotics 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 penetrate the glands and destroy most microbes. In the case of tuberculous prostatitis, treatment lasts 6-9 weeks.
General principles of use
At home, you need to follow the principles of using antimicrobial drugs.
- Adhere exactly to the prescribed dosage, adhere to the regimen and therapy regimen, if a combination of drugs is prescribed.
- The course of therapy must be fully completed. If you interfere with the flow of drug substances into the prostate tissue, then the acute process will quickly turn into chronic. 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 period.
- If in the acute phase, after 3 days of treatment, the pain and temperature do not decrease, you need to come to a doctor's appointment.
Treatment regimens for prostatitis are developed taking into account many factors. Antibiotics that work for one patient may not be effective for another.