Antibiotics for inflammation of the prostate gland are needed. If the disease is not treated, the chances of impotence, infertility, sclerosis, adenoma and gland abscess increase.
When and why antibiotics are needed for prostatitis
The bacterial form of the pathology is found in about 12-18% of patients. An acute process is diagnosed in 5-9 men out of 100 aged 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 gland function, 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 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 germ and not beneficial against another.
Only one antibiotic, chosen taking into account several factors, will have a positive therapeutic effect:
- type of pathogen (determined by bacteriological analysis of the microflora);
- susceptibility of 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%.
- pathogens are rarely detected - gonococci, fungi, Proteus, Klebsiella, gram-positive bacteria - staphylococci and streptococci.
To accurately identify the pathogen, bacteriological inoculation or a more informative method of DNA diagnosis - PCR (polymerase chain reaction) is performed.
When choosing a medicine, 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 to maintain the desired concentration;
- long-term antibacterial effect;
- contraindications and side effects;
- manner of drug administration;
- the route and degree of secretion from the body;
- doses and combinations of drugs;
- 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
In order for the antibiotic to penetrate easily into the gland, it must be fat-soluble, bind poorly to blood proteins, and be active in an alkaline environment.
Aminopenicillin
Today, protected penicillins are preferred, resistant to the destructive action of enzymes - b-lactamases, secreted by the cocal flora. Penicillins are most effective when combined with clavulanic acid.
This group of antibiotics works best in an uncomplicated acute 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, enterobacteriaceae.
Possible side effects:
- nausea;
- diarrhea;
- allergic rash;
- itching;
- people prone 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 prostate gland tissue, so 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.
Medications are considered to have low toxicity; only individual intolerance to cephalosporins is called 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 a high concentration in prostate tissue, so they are considered first-line drugs for the treatment of a chronic process, unless 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 recommended for epilepsy, adolescent boys under 15 - 16 years. Doses are adjusted in men with cardiac, renal pathology, in patients taking antidepressants.
Medications are usually well tolerated. In rare cases, observe:
- redness;
- itching;
- swelling of the vocal cords;
- stomach ache;
- nausea;
- diarrhea;
- insomnia;
- nervousness;
- photosensitization (skin sensitivity to the sun) under UV radiation.
Macrolides
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 chlamydia-induced prostatitis. However, they do not suppress the typical pathology pathogen - Escherichia coli and atypical microorganisms - mycobacteria, clostridia, enterococci.
Side effects are rare, most often in patients with intolerance to this group of antibiotics, serious liver or kidney damage. Rare occur:
- nausea;
- heart;
- dysbiosis;
- koshere;
- 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 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 prostate tissue. The body gets used to Gentamic slowly.
The drug is contraindicated for:
- increased reaction to aminoglycosides;
- severe renal dysfunction;
- Do not lie;
- parkinsonism;
- hearing impairment;
- dehydration.
Nausea, anemia, epilepsy, drowsiness, and impaired kidney function may occur.
Ansamicina
They have a wide spectrum of action against microbes. Medications are chosen if the prostatitis is severe, with mycobacterium tuberculosis (Koch bacillus) - mycobacterium tuberculosis.
tetracycline
They have high natural activity against chlamydial and mycoplasmatic prostatitis. They accumulate in high concentration in the tissues of the organ. Fecal enterococci do 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 conception.
Side effects: intestinal 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. The administration of antibiotic suppositories has the following advantages:
- rapid penetration into glandular tissue through the intestinal wall;
- maximum accumulation of medicinal substance in the gland;
- a minimum of side effects, as the drug is concentrated in the tissues, almost without penetrating into the general bloodstream;
- low doses;
- small number of contraindications, easy application.
The indications for the use of antibacterial suppositories are similar to those for other medicinal forms - tablets, capsules, injections.
Suppositories contain less antibiotics than tablets and solutions, so the course of their use is longer.
List of commonly described suppositories:
- Framycetin suppositories (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 should follow the principles of using antimicrobial drugs.
- Strictly observe the prescribed doses, adhere to the regimen and therapy regimen, if a combination of drugs is prescribed.
- The course of therapy should be completed completely. If you interrupt the flow of medicinal substances into the prostate tissue, then the acute process will quickly turn into a chronic one. 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 one.
- If in the acute phase, after 3 days of treatment, the pain and temperature do not decrease, you should 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.