Antibiotics are needed for inflammation of the prostate gland. 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 the pathology is found in about 12-18% of patients. Acute process is diagnosed in 5-9 men out of 100 at the age of 22-45 years, chronic sluggish course - in 8-11% of patients.
The main task of antibiotic therapy is to inhibit the activity of pathogenic microbes. They relieve inflammation, pain, normalize glandular functions, improve urine flow and blood circulation.
Diagnosis is based on:
- Laboratory tests that confirm the presence of bacteria in semen, urine, prostate secretions;
- Characteristic symptoms;
- Signs of inflammation that are reflected in changes in urine and blood composition.
Important factors when choosing an antibiotic
It is impossible to say 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 embryo and not 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);
- Susceptibility of identified bacteria to specific antibiotics.
Agents that cause 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 identified pathogens - gonococci, fungi, Proteus, Klebsiella, gram-positive bacteria - staphylococci and streptococci.
Bacteriological inoculation or a more informative method of DNA diagnosis - PCR (polymerase chain reaction) is performed to accurately identify the pathogen.
When choosing a drug, keep in mind:
- Range of action - the number and types of pathogens that a particular antibiotic can inhibit;
- The ability to accumulate a medicinal substance in the prostate gland and maintain the desired concentration;
- Long-term antibacterial effect;
- Side effects and contraindications;
- Method of taking the drug;
- The way and speed of excretion from the body;
- Drug doses and combinations;
- Ability to combine the drug with other drugs and methods of therapy;
- Previous antibiotic therapy (onset and duration);
Groups of effective antibiotics and prescription characteristics
In order for an antibiotic to easily penetrate the gland, it must be fat-soluble, weakly bound to blood proteins, and active in an alkaline environment.
Aminopenicillins
Today, preference is given to protected penicillins, which are resistant to the destructive action of enzymes - b-lactamases, which are secreted by the cochlear flora. Penicillins are more effective in combination with clavulanic acid.
This group of antibiotics works better in the acute uncomplicated process and in rare cases of exacerbation of the chronic form of the disease if typical pathogens of the pathology are identified. They do not inhibit chlamydia, mycoplasma, enterobacteriaceae.
Possible side effects:
- Nausea;
- Diarrhea;
- Allergic rash;
- Itching;
- People prone to allergies to medications may experience allergic shock.
Cephalosporins
They act on many pathogens, but not for long. It is effective in acute prostatitis. They accumulate weakly in the prostate gland tissue, so in the chronic process they are used as a "shock" group of antibiotics for a short time.
Staphylococcal flora and clostridia are resistant to cephalosporins.
Medications are considered to have low toxicity; Only individual intolerance to cephalosporins is mentioned as an absolute contraindication.
If the course of the disease is severe, or has recently been treated with antibiotics, resort to the use of cephalosporins in combination with aminoglycosides.
Fluoroquinolones
They have a strong and long-lasting effect on the most typical and atypical bacteria, including Pseudomonas Aeruginosa (Pseudomonas aeruginosa), Mycoplasma, Chlamydia. Fluoroquinolones form in high concentrations in prostate tissue, so they are considered to be the first-line drugs to treat the chronic process, unless resistance to them is suspected. Their effectiveness in suppressing microorganisms is 65-90%.
Due to the long-lasting effect, fluoroquinolones are taken 1-2 times a day. Not prescribed for epilepsy, for adolescent boys 15-16 years. Doses are adjusted in men with heart, kidney pathologies, while taking antidepressants.
Medications are usually well tolerated. In rare cases, pay attention to:
- Rash;
- Itching;
- Swelling of the vocal cords;
- stomach-ache;
- Nausea;
- Diarrhea;
- Insomnia;
- Nervous;
- Photosensitization (skin sensitivity to the sun) under ultraviolet radiation.
Macrolides
Active substances accumulate in the damaged prostate tissue. Macrolides are often prescribed in an acute form without complications and in the chronic course of the disease. High activity of macrolides is observed in chlamydia-induced prostatitis. However, they do not inhibit the typical pathogen of the pathology - Escherichia coli and atypical microorganisms - Mycobacteria, Clostridia, Enterococci.
Side effects are rare, more often in patients with intolerance to this group of antibiotics, with severe liver or kidney damage. Rarely occurs:
- Nausea;
- Heartburn;
- Dysbiosis;
- Urticaria;
- 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 rapidly inhibits the activity of most species of pathogens, including atypical forms, fungi, and mutational microbes that are not sensitive 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 gradually becomes accustomed to gentamicin.
The drug is contraindicated:
- Increased reaction to aminoglycosides;
- Severe renal dysfunction;
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- Parkinsonism;
- Hearing impairment;
- Dehydration.
Nausea, anemia, epilepsy, drowsiness, and impaired renal function may develop.
Ansamycins
They have a wide range of action against microbes. Medications are chosen if the prostatitis is severe, with Mycobacterium tuberculosis (Koch's bacillus) - Mycobacterium tuberculosis.
Tetracyclines
They have high natural activity against chlamydial and mycoplasmal prostatitis. They accumulate in high concentrations in body tissues. Fecal enterococci do not respond to treatment with tetracyclines.
Now they are rarely prescribed due to their high toxicity, penetration into sperm and ability to affect male reproductive cells. 3-4 months should elapse before delivery after completion of therapy.
Side effects: Intestinal disorders, nausea, impaired liver function, allergic reactions, candidiasis.
Combined treatment
If prostatitis is caused by trichomes, ureaplasma, mycobacteria, a combination treatment regimen is developed. It involves a combination of several groups of drugs.
Local treatment
Bacterial anti-inflammatory suppositories are prescribed to increase the effectiveness of treatment. There are several benefits to taking antibiotic suppositories:
- Rapid penetration into glandular tissue through the intestinal wall;
- Maximum accumulation of healing substance in the gland;
- Minimal side effects, since the drug is concentrated in tissues, with almost no general blood flow;
- Low doses;
- Small number of contraindications, easy to use.
The indications for the use of antibacterial suppositories are similar to those used for 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 subscribed suppositories:
- Suppositories with framicetin (aminoglycosides).
- Suppositories with erythromycin (macrolides).
- Chloramphenicol suppositories (active ingredient - chloramphenicol).
- Rifampicin-containing suppositories are effective in rapidly reaching the gland and destroying most microbes. Treatment for tuberculous prostatitis lasts 6-9 weeks.
General principles of use
At home, you should follow the principles of using antimicrobials.
- Follow the prescribed doses, regimen and therapy regimen exactly if a combination of medications is prescribed.
- The course of therapy should be fully completed. If you stop the flow of healing substances into the prostate tissue, then the acute process will quickly turn into 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.
- If in the acute phase, 3 days after treatment, the pain and temperature do not decrease, you need to see a doctor.
The treatment regimen for prostatitis has been developed taking into account many factors. An antibiotic that works for one patient may not work for another.