Antibiotics for prostate gland inflammation are essential. If the disease is left untreated, the chance of impotence, infertility, sclerosis, adenoma and abscess gland increases.
When and why they need antibiotics for prostatitis
The bacterial form of the pathology is found in about 12-18% of patients. An acute procedure is diagnosed in 5-9 men in 100 at the age of 22-45 years, a chronic hypotonic course - in 8-11% of patients.
The main task of antibiotic therapy 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 useful against another.
Only one antibiotic, selected taking into account certain factors, will have a positive therapeutic effect:
- type of pathogen (determined by bacteriological analysis of the microflora).
- the susceptibility 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 - 36%, Trichomonas - 11%;
- Ureaplasma (Ureaplasma) and Mycobacteria (Musoplasma) - 20%.
- pathogens - gonococci, fungi, Proteus, Klebsiella, gram-positive bacteria - staphylococci and streptococci are rarely detected.
For accurate identification of the pathogen, bacteriological vaccination or a more informative method of diagnosis of DNA - PCR (polymerase chain reaction) is performed.
When choosing a medicine, keep in mind:
- 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.
- side effects 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 methods of treatment.
- previous antibiotic treatment (onset and duration).
Groups of effective antibiotics and prescription characteristics
In order for the antibiotic to easily penetrate the gland, it must be fat-soluble, weakly bound to blood proteins, and active in an alkaline environment.
Aminopenicillins
Today, protected penicillins are preferred, resistant to the destructive action of enzymes - β-lactamases, secreted by the grain flora. Penicillins are most effective when combined with clavulanic acid.
This group of antibiotics works best in an acute simple process and in 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:
- motion sickness;
- diarrhea;
- allergic rashes;
- itch?
- People with a tendency for drug allergies may experience allergic shock.
Cephalosporins
They act on many pathogens, but not for long. Effective for acute prostatitis. They accumulate little 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.
Drugs are considered low-toxicity; only individual intolerance to cephalosporins is reported as an absolute contraindication.
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 prostate tissue, therefore, they are considered first-line drugs for the treatment of a chronic process, except when pathogens are suspected to be resistant to them. Their effectiveness in suppressing microorganisms is 65 - 90%.
Due to the prolonged action, fluoroquinolones are taken 1-2 times a day. Not prescribed for epilepsy, adolescent boys under 15 - 16 years. Doses are adjusted in men with cardiac, renal pathology, patients receiving antidepressants.
Medications are usually well tolerated. In rare cases, notice:
- skin rash;
- itch?
- swelling of the vocal cords;
- stomach ache;
- motion sickness;
- diarrhea;
- insomnia;
- nervousness;
- photosensitization (skin sensitivity to the sun) under ultraviolet radiation.
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 macrolide activity is observed in chlamydia-induced prostatitis. However, they do not suppress the typical pathogen of the pathology - Escherichia coli and atypical microorganisms - mycobacteria, clostridia, enterococci.
Side effects are rare, most often in patients with intolerance to this group of antibiotics, severe liver or kidney damage. Rarely appear:
- motion sickness;
- 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 suppresses the activity of most 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 low accumulation (accumulation) in the prostate tissue. The body gets used to gentamicin slowly.
The drug is contraindicated for:
- increased reaction to aminoglycosides.
- severe renal impairment;
- Aren't they lying?
- parkinsonism;
- Hearing problem?
- dehydration.
Nausea, anemia, epilepsy, drowsiness and decreased renal function may occur.
Ansamycins
They have a wide range of action against germs. The drugs are selected if the prostatitis is severe, with tuberculous mycobacterium (Koch bacillus) - mycobacterium tuberculosis.
Tetracyclines
They have a high natural action against chlamydial and mycoplasmal prostatitis. They accumulate in high concentration in the tissues of the organ. Stool enterococcus does not respond to tetracycline therapy.
They are now rarely prescribed due to their high toxicity, ability to penetrate sperm and affect male reproductive cells. After the end of treatment, 3-4 months should pass before conception.
Side effects: bowel disorders, nausea, deterioration of liver function, allergic reactions, candidiasis.
Combined therapy
If prostatitis is caused by hair follicles, ureaplasma, mycobacteria, a combined treatment regimen is developed. It provides a combination of many groups of drugs.
Topical 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 the glandular tissue through the intestinal wall.
- maximum accumulation of the drug in the gland.
- minimal side effects, as the drug accumulates in the tissues, almost without penetrating 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 pharmaceutical forms - tablets, capsules, injections.
Suppositories contain less antibiotics than tablets and solutions, so their use is longer.
List of commonly prescribed suppositories:
- Suppositories with framycetin (aminoglycosides).
- Suppositories with erythromycin (macrolides).
- Chloramphenicol suppositories (active ingredient - chloramphenicol).
- Rifampicin suppositories are effective, which penetrates the gland quickly and destroys most germs. In case of tuberculous prostatitis, the treatment lasts 6-9 weeks.
General principles of application
At home, you should follow the principles of using antimicrobials.
- Follow the prescribed doses exactly, follow the regimen and the treatment regimen, if a combination of drugs is prescribed.
- The course of treatment must be completed. If you stop the flow of drugs into the prostate tissue, then the acute process will quickly turn into years. The remaining microorganisms will continue to act "underground" and develop resistance to antibiotics.
- The typical duration of treatment is at least 8-12 days in the acute period and up to 6 weeks in the years.
- If in the acute phase, after 3 days of treatment, the pain and temperature do not decrease, you should make an appointment with the doctor.
The treatment regimen for prostatitis is developed taking into account many factors. An antibiotic that works in one patient may not work in another.