Antibiotics are needed for inflammation of the prostate gland. If the disease is not treated, the likelihood of impotence, infertility, multiple 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 in 5-9 out of 100 men aged 22-45 years, chronic slow course - diagnosed in 8-11% of patients.
The main task of antibiotic treatment is to suppress the activity of pathogenic microbes. They eliminate inflammation, pain, normalize glandular function, improve urine flow and blood circulation.
The diagnosis is based on:
- laboratory tests confirming the presence of bacteria in sperm, 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 say which antibiotic is best. Bacterial inflammation in the tissue of the prostate gland is caused by organisms that cause many diseases, so one drug may be effective against one type of microbe and may not be beneficial against another.
An antibiotic selected with only certain factors in mind will have a positive therapeutic effect:
- type of pathogen (determined by bacteriological analysis of microflora);
- sensitivity 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%.
- Rarely found 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, consider:
- spectrum of action - the number and types of pathogens that a particular antibiotic can suppress;
- the ability of a drug to accumulate in the prostate gland and maintain the desired concentration;
- long-term antibacterial effect;
- adverse reactions and contraindications;
- method of drug administration;
- the way and speed of excretion from the body;
- doses and combinations of drugs;
- ability to combine the drug with other drugs and therapies;
- previous antibiotic treatment (onset and duration);
Effective antibiotic groups and prescription features
For an antibiotic to easily penetrate the gland, it must be soluble in fat, poorly bound to blood proteins, and active in an alkaline environment.
Aminopenicillins
Today, penicillins, which are resistant to the destructive effects of enzymes secreted by the coccal flora - b-lactamases, are preferred. Penicillins are more effective when combined with clavulanic acid.
This group of antibiotics works better in a simple uncomplicated process and in rare exacerbations of the chronic form of the disease, if the typical pathogens of the pathology are identified. They do not bury chlamydia, mycoplasma, enterobacteria.
Possible side effects:
- nausea;
- diarrhea;
- allergic rashes;
- itching;
- People prone to drug allergies may experience allergic shock.
Cephalosporins
They act on many pathogens, but not for long. Effective for acute prostatitisThey accumulate poorly in the tissue of the prostate gland, so they are used as a "shock" group of antibiotic action for a short time in a chronic process.
Staphylococcal flora and clostridia are resistant to cephalosporins.
Drugs are considered low toxicity, only individual intolerance to cephalosporins are called absolute contraindications.
If the course of the disease is severe or has recently been treated with antibiotics, cephalosporins are used in combination with aminoglycosides.
Fluoroquinolones
Pseudomonas Aeruginosa (Pseudomonas aeruginosa) has a strong and long-lasting effect on most typical and atypical bacteria, including mycoplasma and chlamydia. Fluoroquinolones are highly concentrated in prostate tissue, so they are considered first-line drugs to treat the chronic process, except when pathogens are suspected to be resistant to them. Their effectiveness in suppressing microorganisms is 65-90%.
Due to the long-term effect, fluoroquinolones are taken 1-2 times a day. Epilepsy is not prescribed for adolescent boys under 15-16 years of age. Doses are adjusted in men with heart and kidney pathology, in patients taking antidepressants.
Medications are usually well tolerated. Rarely observe:
- stupid;
- itching;
- swelling of the vocal cords;
- stomach pain;
- nausea;
- diarrhea;
- insomnia;
- nervousness;
- photosensitization under ultraviolet radiation (skin sensitivity to the sun).
Macrolides
The active ingredients accumulate in the affected prostate tissue. Macrolides are often prescribed in the acute form and in the chronic course of the disease without complications. 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 common in patients with intolerance to this group of antibiotics, severe liver or kidney damage. Rarely occurs:
- nausea;
- heartburn;
- dysbiosis;
- hives;
- 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 quickly suppresses the activity of many types of pathogens, including atypical forms, fungi and mutated microbes that are not sensitive to other groups of antibiotics.
In the chronic course of bacterial prostatitis, aminoglycosides are not prescribed due to the low accumulation (accumulation) in the tissue of the prostate gland. The body slowly gets used to gentamicin.
The drug is contraindicated for:
- increased reaction to aminoglycosides;
- severe renal dysfunction;
- Do not lie to me;
- parkinsonism;
- hearing impairment;
- dehydration.
Nausea, anemia, epilepsy, drowsiness and impaired renal function may occur.
Ansamycins
They have a wide range of antimicrobial activity. When prostatitis is severe, the drug is distinguished from Mycobacterium tuberculosis (Koch bacillus) - mycobacterium tuberculosis.
Tetracyclines
They have high natural activity against chlamydia and mycoplasma prostatitis. They accumulate in high concentrations in the tissues of the body. Fecal enterococci do not respond to treatment with tetracyclines.
Now they are rarely prescribed due to their high toxicity, ability to enter sperm and affect male reproductive cells. 3-4 months after conception should be completed after therapy.
Adverse reactions: intestinal disorders, nausea, impaired liver function, allergic reactions, candidiasis.
Mixed treatment
If prostatitis is caused by trichomonas, ureaplasma, mycobacteria, a combined treatment regimen is developed. Provides a combination of several drug groups.
Local treatment
Candles are prescribed for bacterial inflammation of the prostate to increase the effectiveness of treatment. The use of antibiotic suppositories has the following advantages:
- rapid penetration of glandular tissue from the intestinal wall;
- maximum accumulation of the drug in the gland;
- minimal side effects, because the drug is concentrated in the tissues almost without penetrating the general circulation;
- low doses;
- small number of contraindications, easy to apply.
The instructions for use of antibacterial suppositories are similar to those for other dosage forms - tablets, capsules, injections.
Suppositories contain fewer antibiotics than tablets and solutions, so they last longer.
List of commonly prescribed suppositories:
- Suppositories containing framisetin (aminoglycosides).
- Suppositories with erythromycin (macrolides).
- Chloramphenicol suppositories (active ingredient - chloramphenicol).
- Candles containing rifampicin are effective, which quickly penetrates the gland and kills most germs. Treatment of tuberculous prostatitis lasts 6-9 weeks.
General principles of application
At home, you should follow the principles of using antimicrobial drugs.
- Strictly follow the prescribed doses, if a combination of drugs is prescribed, follow the regimen and therapy regimen.
- The course of therapy must be completed completely. If you stop the flow of drugs into the prostate tissue, the acute process will quickly turn into a chronic process. The remaining microorganisms will continue to operate "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 the pain and temperature do not decrease after 3 days of treatment in the acute phase, it is necessary to see a doctor.
The treatment regimen for prostatitis is developed taking into account many factors. An antibiotic that affects one patient may not affect another.