Antibiotics are commonly used. for the treatment of prostatitis in acute and chronic form, even if the symptoms are rather weak. However, antimicrobial therapy is necessary when prostatitis is infectious, non-bacterial prostatitis does not require such treatment.
Antibiotics for prostate
With infectious or bacterial prostatitis antibiotic choice depends on the virus of the pathogen.
Specialist prescribes antibiotic therapy only after research sensitivity to a specific antibiotic, then he will decide which particular antibiotic will work in each specific case, and this particular the choice affects the effectiveness and efficiency of treatment.
Note! Self-prescription is not allowed, as there is a risk to aggravate the course of the disease. Instead of the death of pathogenic microbes, you can cause the death of the desired microorganisms with an incorrectly chosen antibiotic or increase the resistance of the microbes to the drug.
Benefits of Antibiotic Treatment
Prostatitis is a disease that has enough high relapse ratetherefore, antibiotic therapy, if prescribed by a doctor, is important.
The advantage of antibiotic treatment of prostatitis is the mechanism of their impact on the body. On this basis, they are divided into two large groups: bacteriostatic antibiotics - do not kill microbes, but block their reproduction and the second group bactericidal, from exposure to the drug belonging to this group, the microbe dies and is removed from the human body.
For the treatment of most infections in the human body is enough bacteriostatic action, but for serious violations of the immune system or weak defense mechanisms in the infectious focus, antibiotics with bactericidal properties.
|Ofloxacin||Ointment, injection, tablets 200 mg and 400 mg.|
|Ciprofloxacin||Tablets, solution for intravenous infusions (infusions), eye and ear drops, as well as eye ointment.|
|Norfloxacin||Film coated tablets for oral administration.|
|Levofloxacin||Tablets 250 mg and 500 mg. , eye drops 0.5%, solution for infusions 0.5%.|
|Doxycycline||Ampoules in powder form (for the preparation of a solution for intravenous drip), capsules.|
|Tetracycline||Tablets, coated, ointment for external use of 3%, ophthalmic ointment 1%.|
|Oxacillin||Powder for solution for intramuscular and intravenous administration, tablets.|
|Amoxicillin||Capsules, granules (for suspension).|
|Amoxiclav||Tablets, powder for suspensions, lyophilized powder for injections.|
|Flemoxin||Tablets, powder for suspensions, granules from which a solution is prepared for ingestion, in dry form for reconstitution and for preparation of a solution for injection.|
Cephalosporins group drugs
|Ceftriaxone||Powder for solution for intramuscular and intravenous administration.|
|Ceftazidime||Powder for the preparation of injection solution.|
|Ceftibuten||Capsules, powder for suspension.|
Preparations group Macrolides
|Sumamed||Tablets, capsules, powder for suspension.|
Important! The dosage should be determined by the attending physician, depending on the patient's condition, the severity of the inflammation, the presence of diseases in history.
With chronic prostatitis
The specialist may appoint any antibiotic from the listed classesFor example, the third generation cephalosporin, penicillin. May apply fluoroquinols, especially in the case of the ineffectiveness of other drugs.
Important! The specific scheme of application will depend on the exact diagnosis, tolerability of a substance, sensitivity to the drug.
With bacterial form
In this case, an antibiotic belonging to the group may be prescribed. tetracycline, if the bacterium that caused the disease belongs to mycoplasma or chlamydia.
Drugs from the group macrolide appointed when detecting gonorrhea, ureaplasmosis, chlamydia, mycoplasmosis.
Side effects and contraindications
The main contraindication in the appointment of an antibiotic for prostatitis is hypersensitivity of the body to the composition of the drug. The second contraindication is age restrictions, as well as antibiotics and many other drugs are not prescribed for serious pathologies in the kidneys and liver.
Side effects that are possible when taking antibiotics are most often associated with discomfort in the stomach and intestines: nausea, heaviness, constipation, diarrhea. Therefore, for example, tetracycline antibiotics in the form of tablets or capsules it is better to take standing with a whole glass of water in order to avoid irritation and damage to the gastrointestinal mucosa.
On the part of the hematopoietic system, there may be a deficiency of red blood cells, leukocytes, platelets, and anemia may occur. Side effects can occur and in the form of headaches, sleep disturbances, fatigue.
It is important! If any symptoms are noticed, this information should be communicated to the doctor, as the doctor may change the antibiotic if intolerance arises to another one that is similar, but with the least possible side effects.
Classification of chronic prostatitis
There are three main forms of chronic prostatitis:
- Chronic bacterial prostatitis is a lesion of the prostate gland associated with the development of pathogenic microflora. It proceeds with symptoms similar to the symptoms of acute prostatitis (pain when urinating, the presence of pus and blood in urine, etc.), but has more blurred (lightened) manifestations.
- Chronic non-bacterial prostatitis is a type of male prostate lesion caused by causes other than pathogenic bacteria (for example, trauma or the formation of prostate stones) detected in the presence of infectious diseases. However, the name of the pathology concerns only the etiology of the disease, and not its course, since in the process of pathogenesis there is a development of pathogenic microflora identical to other prostatitis varieties.
- Chronic asymptomatic prostatitis is a pathology of the prostate gland caused by the presence of pathogenic microflora in the prostate area and is asymptomatic or almost asymptomatic. Important! If you suspect this type of disease, usually detected during diagnosis based on the presence of such pathological phenomena as leukocyturia and / or bacteriuria, additional diagnosis is necessary. This is due to the similarity of the course of chronic asymptomatic prostatitis with prostate cancer.
Thus, regardless of the type of chronic prostatitis, in all cases the use of antibiotic drugs is recommended. Drugs, which appear when prescribing therapeutic practice by the drugs of choice, will be described below. And you need to start by offering readers antibiotics for prostate chronic list.
What are antibiotics?
In recent years, the resistance of bacteria to certain drugs has increased dramatically, so before starting treatment with antibiotics for prostatitis in men, it is necessary to examine the patient for the entire group of STIs and the pathogenic flora to determine the resistance of certain microorganisms to certain drugs.
What antibiotics to treat prostatitis at home? The following groups of antibacterial drugs are distinguished (the best antibiotics for prostatitis in men):
- Penicillins - ampicillin, amoxiclav, amosin, amoxicillin. In the past, such antibiotics were actively used in inflammation of the prostate, with the advent of the most active antibacterial drugs, they practically lost their clinical significance due to the increased number of negative bacteria resistant to penicillins.
- Macrolides - erythromycin, josamycin, azithromycin, roxithromycin, clarithromycin. These antibiotics have prostatitis with a wide spectrum of action and low toxicity.
- Tetracyclines - vibromycin, tetracycline, doxycycline. Have activity against gonococci, chlamydia, mycoplasma. Often used in the treatment of chronic infectious prostatitis caused by the above pathogens.
- Fluoroquinolones - ciprofloxacin, ofloxacin, lomefloxacin, levofloxacin. Often used for complex treatment of chronic inflammation of the prostate, and in acute uncomplicated inflammation of the prostate gland (efficacy up to 100%). Possess high activity and low toxicity (do not violate the intestinal microflora).
- Cephalosporins - cefotaxime, ceftriaxone, cefixime. Actively used in the treatment of acute forms of bacterial prostatitis. These are good antibiotics for prostatitis, they have a wide spectrum of action and high activity against pathogenic bacteria.
At the same time, modern medicine uses antibiotics for prostatitis or other diseases due to their capabilities:
- quickly destroy the source of the disease and eliminate inflammation,
- produce substances that kill or stop the growth of bacteria and large viruses, but are safe for the cells of the microorganism,
- act when applied externally (suppositories, ointments) and other methods of administration: intramuscularly, orally, intravenously,
- fight simultaneously with many pathogens of diseases (broad-spectrum antibiotics).
What are the most effective antibiotics?
To cure or reduce the manifestations of infectious prostatitis, strictly follow the recommendations of the doctor. Begin the course only after the diagnosis, when the doctor has understood the nature of the disease. Self-treatment at home is fraught with devastating consequences, disruptions in the work of body systems.
The table shows the list and dosages of popular antibiotics for prostatitis:
1 tablet (1000 mg)
2 tablets (500 mg)
2 times a day
Recommendations for antibiotic therapy
Side effects from taking antibiotics can cause no less trouble than exacerbation of prostatitis. Characteristic disadvantages of each group of drugs:
- Penicillins: rash, dermatitis, diarrhea,
- Cephalosporins: diarrhea. Rash and fever are rarely fixed,
- Macrolides: nausea, vomiting. Sometimes there is colitis, cholestatic jaundice,
- Fluoroquinolones: abdominal pain, diarrhea.
Diarrhea is the most common side effect of taking antibiotics. It is provoked by two reasons: an imbalance of the intestinal microflora, an overgrowth of bacteria called Clostridium difficile. Prevent and eliminate diarrhea can be a parallel intake of pro-and prebiotics.
For the successful treatment of prostatitis, especially chronic, in addition to taking antibiotics, the following types of treatment are used:
- Prostate massage is the best way to improve blood supply and the discharge of inflammatory secretions from the prostate gland,
- nonsteroidal anti-inflammatory drugs - not used in parallel with fluoroquinolones,
- herbal preparations
- Alpha-blockers - Tamsulosin, Doxazosin, Terazosin.
Some reviews of men who treated prostatitis with antibiotics:
- Andrei, 42 years old: “During the next exacerbation of prostatitis after the tests, Flemoxin Solutab and Vitaprost candles were prescribed. After the course of such a combination therapy, it became much easier, but, fearing a relapse, he himself drank propolis tincture for some time. ”
- Oleg, 33 years old: “There was acute prostatitis, antibiotic treatment with Tetracycline tablets was the only one that came up, because in general there are few antibiotics that I can use for treatment. Almost immediately feel better. Antibiotic helped quickly. The only thing was that there was heartburn in the morning, so I drank medicine to restore the flora. ”
- Dmitry, 39 years old: “Lubricated symptoms in the form of urination problems were periodically disturbed, but blamed on exacerbations of hemorrhoids. As a result, they diagnosed asymptomatic bacterial prostatitis. Long pricked "Ceftriaxone", parallel to put candles "Prostatilen", and at the end of the course - also candles with sea buckthorn. In general, the result is positive. "
- Sergey, 40 years old: “During exacerbation of chronic prostatitis, Gentamicin injections were prescribed, after which the muscles of the legs and buttocks ached, but the effect was felt almost immediately. At the end of the course, put candles "Uroprost" and took immunomodulators. While the prostate does not remind of itself, although half a year has already passed. ”
In order to effectively cure an ailment, it is necessary to make a diagnosis that will show the type of bacteria that cause the disease in a particular patient, their sensitivity to medications. Based on the test results, the doctor makes a decision on how to treat chronic prostatitis or an acute form of the disease.
When is antibiotic treatment indicated?
Prostatitis can be triggered by bacteria, or it can be non-infectious. In the latter case, the appointment of antibiotics, as a rule, is not required. They should be taken if prostatitis has an acute or chronic course against the background of the lesion of the prostate gland by bacteria. In this case, the severity of symptoms does not matter. Often, chronic bacterial prostatitis generally proceeds without any signs indicating the presence of inflammation. In addition, the appointment of antibacterial agents may be due to the conduct of test therapy, even against the background of abacterial inflammation.
It is very important to observe all the diagnostic points of prostatitis in order to find out the cause of inflammation, identify the pathogenic agent and determine its individual sensitivity to a specific drug:
The first stage of diagnostic studies. The first stage includes:
Blood collection for clinical analysis.
Urine collection for bacterial sowing, for carrying out a three-stacked sample.
Fence scraping the epithelium of the urethra for the detection of STIs by PCR, including chlamydia, mycoplasmosis, gonorrhea, etc.
Prostate secretion collection for a comprehensive study.
Ultrasound examination of the prostate gland.
Blood sampling to determine the level of PSA in it, which eliminates prostate cancer.
The second stage of diagnostic studies: When the content of leukocytes in prostatic secretions does not exceed 25, then testing with the help of Omnick (tamsulosin) is indicated. It is taken for a week, after which the secret is taken for analysis again.
Examination results determine the type of prostatitis.
Abacterial prostatitis. When, even against the background of the administration of the Omnick drug, there is no leukocyte jump, and the bacteria are not detected in the cultures, the inflammation of the prostate gland is defined as non-bacterial. This condition is called pelvic pain syndrome, which requires symptomatic therapy.
At the same time, the patient is awaiting a test result for tuberculosis that will be ready in at least 10 weeks. If they are positive, then the patient is placed in a tuberculosis dispensary (in the urology department).
Tuberculous prostatitis. The disease can be determined by prostate biopsy. Infection most often affects not only the prostate gland, but also the epididymis, urinary system, seminal vesicles. Despite the fact that in the Russian Federation, tuberculosis becomes epidemic in nature, and not only the lungs, but also other organs are affected, the diagnosis of this disease presents certain difficulties. The danger also lies in the fact that increasingly common special forms of the disease caused by bacteria resistant to treatment.
Tuberculosis of the genitourinary system of men often develops hidden, not giving acute symptoms. Laboratory tests can give a false negative result, especially if a man takes antibiotics for prostate from a group of fluoroquinones.
Symptoms that may indicate prostate tuberculosis are subfebrile, aching or burning pains in the perineal region, in the lumbosacral region, and increased fatigue. The age of patients with most commonly detected tuberculous prostatitis is in the range between 20-40 years.
Bacterial infectious prostatitis. In that case, if the analysis of prostate secretion indicates leukocytosis with an increase in the number of leukocytes more than 25, and the Omnik method does this figure higher, then it makes sense to talk about bacterial or latent infectious prostatitis. Antibacterial therapy in this case is mandatory.
The PCR method allows even a day later to identify the causative agents of genital infections, so the doctor will be able to recommend taking one or another drug when you return. The drug of choice is the means in respect of which the established flora has maximum sensitivity, or an antibiotic active against most pathogenic agents is prescribed.
If the effect of the treatment is absent, it is necessary to wait for the result of bacteriological seeding, which allows you to more accurately determine the choice of means.
What are the most effective antibiotics for prostate?
It is impossible to identify any specific antibiotic from bacterial prostatitis that would help all men without exception in treatment. It all depends on the sensitivity of the germs that caused the disease in each case.
Independent therapy with the use of antibacterial and other means, independent diagnosis of the disease is impossible. An effective drug can only be selected when a particular bacterial agent is known, after doctors determine its susceptibility to drugs. Only the doctor decides how long it will be necessary to carry out the treatment, which doses of the drug are necessary for this. Most often, experts prescribe a broad-spectrum drugs.
If specific bacteria are not detected, it is recommended to take medicines, based on the seeding of prostate secretion. There, non-specific streptococci and staphylococci are most often identified.
Treatment involves an integrated approach and does not last for 30-60 days:
Prescribed reception antibacterial agents.
Shows the reception of NSAIDs.
It is necessary to accept the means directed on normalization of blood circulation.
Immunostimulating therapy is underway.
Assigned to receive vitamin complexes, or monovitamins.
In some cases, phytotherapy is prescribed.
Thermal microwave therapy, prostate massage can be performed only when tuberculosis is excluded. Otherwise, the disease may worsen, which will worsen the patient's condition.
Preparations of sedation, antidepressants are recommended for men with chronic prostatitis against the background of the development of depressive moods, with a deterioration in the quality of life. In this case, psychotropic drugs are auxiliary.
Depending on which pathogen will be detected, one or another antibiotic from prostatitis is selected.
The sensitivity of pathogenic microorganisms to antibacterial drugs is presented in the table:
In which cases use antibiotics for prostatitis?
Antibiotics for prostatitis for men are strong medicines that quickly help to level the bacterial process in the body. However, they are appointed for strict medical reasons, because they have side effects and contraindications. Therefore, when a man addresses a doctor, diagnostics is first carried out.
If the nature of the disease is non-infectious, then there is no point in antibiotic therapy. It helps only in cases where the pathology of an acute or chronic form is provoked by pathogenic microorganisms. The degree of intensity and severity of symptoms does not matter. It often happens that the bacterial form of the disease proceeds without symptoms that would indicate signs of inflammation. To make a diagnosis without appropriate laboratory research is impossible.
It is worth knowing: it is the diagnostic results that determine the type of prostatitis in men, respectively, taking into account this information, it is decided whether to carry out antibiotic therapy or whether it is inappropriate.
The first stage of diagnostic measures includes:
- General blood analysis,
- Urine testing with bacterial culture,
- Smear from the urethral canal by PCR to determine infections that are transmitted during unprotected intercourse (gonorrhea, chlamydia, syphilis, etc.),
- Taking prostatic secrets to study its composition,
- Ultrasound of the glandular organ,
- Blood test for PSA to rule out prostate cancer.
If the content of leukocytes in a secret is not more than 25, then it is required to carry out testing by means of the drug Omnik. It must be taken within seven days, after the prostatic secret is investigated again.
When a patient has not seen an increase in the concentration of leukocytes in the patient during the use of the Omnick medication, microbes have not been identified in the crops, the abacterial form of the disease is diagnosed. In this case, the antibiotic is not prescribed for prostatitis, only symptomatic therapy is needed. If a high content of leukocytes is observed in the analyzes, and the use of Omnik provokes a leukocyte leap, then they speak of a latent infectious disease or a bacterial form of prostatitis. In this case, antibiotics are always prescribed.
With the help of the polymerase chain reaction method, pathogens of genital infections are detected, so a medical specialist can recommend the use of one or another antibacterial agent. The medication of choice is the medicine for which the maximum susceptibility of bacteria has been established, or an antibiotic characterized by a wide range of effects.
Amoxiclav with prostate discharged in many cases. This drug belongs to a broad spectrum of antibiotics. The structure includes two active ingredients - amoxicillin plus clavulanic acid. The advantages include high efficiency in the fight against pathogenic microorganisms that produce beta-lactamase. This provides a pronounced therapeutic result against many bacteria. The downside is that the tool has virtually no effect on ureaplasma, mycoplasma, chlamydia.
The list of antibiotics for prostatitis in men (the pros and cons of drugs):
- Augmentin - broad-spectrum tablets. Plus drugs: resistant to microbes that synthesize beta-lactamase. Also, the drug quickly destroys gram-positive and gram-negative bacteria that provoke inflammation in the glandular organ. Treatment lasts 7-10 days. The dose is determined individually. The disadvantage is the high cost, which can reach $ 30-40.
- Gentamicin has a high degree of antibacterial activity against gram-negative microbes. Helps to get rid of salmonella, protea, klebsiella and other pathogens. It is inexpensive - $ 1-2. A significant disadvantage is the limited impact, in other words, the pills will not help from some bacteria, so the tool is often used in the combined scheme.
- Suprax refers to the third generation of drugs. Treats prostatitis, which is triggered by gonococci, Proteus, Escherichia coli. There are several forms of release, which allows you to choose the best option for the treatment of prostatitis in men. Minus: does not help from ureaplasma, chlamydia, enterococci.
Important: the use of Supraksa often leads to side effects. Men complain of dryness in the oral cavity, digestive disorders, diarrhea, increased gas formation, abdominal pain, nausea, severe headaches. In the presence of the described symptoms, the decision on the appropriateness of further admission is taken by the doctor.
Treatment of prostatitis with local antibiotics - candles, is a good way to act directly on the inflammatory focus. The advantages of suppositories include a quick result, the elimination of alarming symptoms, leveling the inflammatory process in a short time. Generally speaking, local antibiotics quickly inhibit pathogens, which speeds recovery.
Candles Rifampicin is a semi-synthetic drug with antibacterial activity. Helps to get rid of chlamydia, protea, staphylococcus and other bacteria. This drug is made by prescription only. Enter one candle per day, the duration of therapy is not more than seven days. During treatment is strictly prohibited the use of alcoholic beverages. The drug has a low cost, quick effect, rarely leads to the development of side effects.
- Violation of the liver and kidneys,
- Established hypersensitivity to the antibiotic.
Vitaprost Plus is composed of lomefloxacin substance. This component has a detrimental effect on bacteria. Suppositories also have an anti-inflammatory effect, which suppresses negative symptoms. Advantages: no contraindications. Cons: does not help cure prostatitis, which has developed as a result of streptococcal or staphylococcal infection.
Proktosedil - local drug, which is available in the form of gelatin capsules for rectal administration. Unlike "standard" candles, which are based on solid fat, capsules dissolve at the "destination" much faster, which is an advantage of the drug. The dosage is one or two candles per day, the duration of treatment is determined individually. Minor minus - slight burning after administration of the capsule. It is self-leveled within 2-3 minutes after application.
Antibiotics are prescribed only for the treatment of bacterial prostatitis, the etiology of which was confirmed by laboratory tests. Often combine tablets and suppositories to get a more pronounced therapeutic effect. Men who are prone to intestinal disorders, while taking antibiotics should take absorbents and vitamins.
Ciprofloxacin ® (Cifran ®, Cifran OD ®, Ciprobai ®, etc.)
Antibacterial agent with a broad spectrum of antimicrobial effects, which is due to its ability to inhibit the DNA gyrase of pathogens, disrupting the synthesis of the tank. DNA and leading to irreversible changes in the microbial wall and cell death.
Ciprofloxacin ® does not affect ureaplasma, treponema and clostridium differential.
Antibiotic is contraindicated:
- up to eighteen,
- in the presence of colitis caused by the receipt of antimicrobial agents in history,
- in the case of individual hypersensitivity to fluoroquinolones,
- patients with porphyria, severe renal and hepatic insufficiency,
- simultaneously with tizanidine ®,
- epileptics and people with severe CNS lesions,
- in violation of cerebral circulation,
- in patients with lesions of tendons associated with fluoroquinolones.
Features of the appointment Ciprofloxacin ®
To reduce the risk of adverse events recommended during treatment:
- eliminate physical exertion and excessive insolation,
- use high SPF cream,
- increase drinking regime.
Ciprofloxacin ® is not combined with non-steroidal anti-inflammatory drugs, due to the high risk of seizures. It is also able to enhance the toxic effect on the kidneys of Cyclosporin ®.
When combined with tizanidine ®, a sharp drop in blood pressure, up to collapse, is possible.
Applying with anticoagulant therapy may cause bleeding. Enhances the action of sugar-lowering tablets, increasing the risk of hypoglycemia.
When combined with glucocorticosteroids, the toxic effect of the fluoroquinolones on the tendons is enhanced.
In combination with beta-lactams, aminoglycosides, metronidazole and clindamycin, synergistic interaction is observed.
Adverse effects of treatment
- violation of the gastrointestinal tract,
- neurosis, anxiety, hallucinations, nightmares, depression,
- ruptures of tendons, arthralgia, myalgia,
- perversion of taste, reduction of smell, impaired visual acuity,
- nephritis, renal dysfunction, crystalluria, hematuria,
- cholestatic jaundice, hepatitis, hyperbilirubinemia,
- decrease in the number of platelets, leukocytes, hemolytic anemia,
- hearing loss (reversible)
- lowering blood pressure
- colitis and diarrhea.
Calculation of the dose and duration of treatment
From 500 to 750 milligrams twice a day. When using drugs with prolonged action (Cifran OD® 1000 mg), a single dose is possible. The maximum dose per day is 1.5 grams.
In the case of a severe form of the disease, therapy begins with intravenous administration, with a further transition to oral administration.
The duration of treatment depends on the severity of the disease and the presence of complications. A standard course of therapy ranges from ten to 28 days.
How to treat bacterial prostatitis (acute and chronic) in men with antibiotics?
For the eradication of the pathogen and the elimination of the inflammatory process use a wide range of drugs that work against the most common pathogens.
The list below presents the most effective antibiotics for prostatitis in men with names.
- Norfloxacin ® (Nolitsin ®, Norbaktin ®),
- Ciprofloxacin ® (Ciprolet ®, Tsiprobay ®, Cyfran OD ®, Ciprinol ®, Quintor ®, Quipro ®),
- Levoflokstsina ® (Tavanik ®, Glevo ®, Levolet R ®),
- Ofloxacin ® (Tarivid ®, Zanonin OD ®),
- Moxifloxacin ® (Avelox ®).
II) Fluoroquinolones in combination (the best antibiotics for prostatitis caused by mixed infection):
- Ofloxacin ® + Ornidazole ® (Ofor ®, Polymic ®, Combiflox ®),
- Ciprofloxacin ® + Tinidazole ® (Cifran CT ®, Ciprolet A ®, Ciprotin ®, Zoxan TK ®),
- Ciprofloxacin ® + Ornidazole ® (Orzipol ®).
- Cefaclor ® (Vercef ®),
- Cefuroxime-axetil ® (Zinnat ®),
- Cefotaxime ® (Cefabol ®),
- Ceftriaxone ® (rofecin ®),
- Cefoperazone ® (Medocef ®, Cefobite ®),
- Ceftazidim ® (Fortum ®),
- Cefoperazone / sulbactam ® (Sulperazon ®, Sulzonzef ®, Backperazone ®, Sultsef ®),
- Cefixime ® (Supraks ®, Sorcef),
- Ceftibuten ® (Cedex ®).
IV) Inhibitor-resistant penicillins (Axicillin / Clavulanic acid ®):
- Clarithromycin ® a (Kriksan ®, Fromilid ®, Klacid ®),
- Azithromycin (Azivok ®, Azitrotsin ®, Zimax ®, Zitrolit ®, AzitRus ®, Sumamed forte ®),
- Roxithromycin (Roxide ®, Rulid ®).
VI) Tetracyclines (Doxycycline ®):
VII) Sulfanilamides (Sulfamethoxazole / Trimethoprim ®):
Sumamed ® for prostatitis: features of the appointment and treatment regimen
The drug has a broad spectrum of bactericidal activity due to the irreversible binding of bacteria to the 50S subunit of ribosomes and the inhibition of the synthesis of structural components of the microbial wall. When reaching a high therapeutic concentration in the outbreak of inflammation, the antibiotic begins to act bactericidal.
Azithromycin ® (active. Substance) is prescribed only in the early stages, with a mild course of the disease or if there are contraindications to other antibiotics.
Sumamed ® is effective against methicillin-sensitive strains of staphylococcus, penicillin-sensitive strains of streptococcus, gram-negative aerobes, chlamydia, mycoplasma.
Methycillin-resistant staphylococcus, penicillin-resistant streptococci, enterococci, erythromycin-resistant gram-positive microbes are resistant to Azithromycin ®.
Azithromycin ® treatment regimen
Sumamed ® should be taken one hour before or two hours after eating the food.
With a five-day course, the dose of an antibiotic on the first day is one gram. Next, appoint 500 milligrams for four days.
With a three-day treatment, one gram of Sumamed ® is indicated for three days.
The drug is not appointed:
- individuals with individual hypersensitivity to macrolides,
- severe kidney and liver diseases,
- against the use of ergotamine and dihydroergotamine,
- with severe arrhythmias.
It is used with caution in patients with myasthenia, heart failure, hypokalemia and hypomagnesemia, disorders of the kidneys and liver of mild and moderate severity.
Alcohol, food and antacids reduce the bioavailability of Sumamed ®. Not recommended for prescribing to persons receiving anticoagulants. It is poorly combined with oral hypoglycemic agents, there is a risk of hypoglycemia. Shows antagonistic interaction with lincosamides and synergistic with chloramphenicol ® and tetracycline ®. It has a farm. incompatibility with heparin.
Other antibiotics for acute and chronic prostatitis
Biseptol ® is a combined agent from the group of sulfonamides, containing sulfamethoxazole and trimethoprim. Biseptol exhibits pronounced bactericidal activity and has a broad spectrum of action.
Sulfamethoxazole has a structural similarity with para-aminobenzoic acid, thanks to which it inhibits the synthesis of dihydrofolic acid. This mechanism is enhanced by the action of Trimethoprim ®, which interferes with protein metabolism and the processes of division in the microbial cell.
The combined composition ensures the effectiveness of Biseptol even against bacteria that are resistant to sulfonamides. Inactive against mycobacterium, pyocyanic sticks and spirochetes.
Biseptolum is contraindicated in:
- the presence of structural changes in the liver parenchyma,
- severe renal failure with creatinine clearance less than 15 ml / minute,
- blood diseases (aplastic, megaloblastic, B12 and folic deficiency anemia, agranulocytosis and leukopenia),
- increased bilirubin level
- glucose-6-phosphate dehydrogenase deficiency
- bronchial asthma,
- thyroid diseases,
- individual intolerance to the components of the drug.
Unwanted effects from the application:
- disorders of the gastrointestinal tract,
- decrease in the number of leukocytes, platelets, granulocytes,
- peripheral neuropathy,
- headaches, dizziness, confusion,
- diarrhea and pseudomembranous colitis,
- aseptic meningitis,
- abnormal liver function
- interstitial nephritis and toxic nephropathy,
- allergic manifestations
- hypoglycemic states
Calculation of dosages
For the treatment of prostatitis, an antibiotic is prescribed in 4 tablets with a dosage of 480 milligrams per day.
In the case of a severe form of the disease, the dosage can be increased to six tablets. Biseptol is recommended to be consumed twice a day, after eating, washing it down with plenty of cooled boiled water. The course of therapy is 10 days or more, depending on the severity of the treatment.
Interaction Biseptola with other drugs
- Not compatible with thiazide diuretics due to the high risk of bleeding due to a decrease in platelet count. Also not recommended combination with indirect anticoagulants.
- When prescribed to patients with diabetes mellitus, taking sugar-reducing pills, increases the likelihood of developing hypoglycemic conditions.
- When combined with barbiturates increases the risk of folic deficiency anemia.
- Due to administration with ascorbic acid or other urine-acidifying preparations, crystalluria may occur.
During Biseptol ® use, it is necessary to increase the drinking regime and eliminate cabbage, spinach, carrots and tomatoes from the diet. When conducting long-term therapy or in the case of use of the drug in the elderly, it is recommended that the additional appointment of folic acid.
If necessary, long-term antimicrobial therapy shows the appointment of an oral solution of Intraconazole ®, at the rate of 400 milligrams per day for seven days.
The use of Tamsulosin ® is highly effective.
This is a specific α blocker.1- adrenergic receptors of smooth muscles of the prostate gland. The action of the drug leads to a decrease in muscle tone (reducing stagnation) and improving urine flow.
Organotropic preparations have also proven themselves well. The most commonly used is Prostakol ®. This is a polypeptide agent of animal origin, having a tropism for human prostate tissue. Prostacol ® reduces the severity of edema, eliminates pain and discomfort, reduces the inflammatory response and increases the functional activity of the gland's own cells. It also reduces platelet aggregation, acting as a prophylaxis for pelvic vascular thrombosis.
As an additional treatment in order to accelerate recovery, increase the body's resistance to bacteria and reduce the severity of the inflammatory response, immunotherapy is prescribed (Timalin®).
To eliminate stagnation and restore the functions of the prostate gland, prostate massage and pelvic floor muscle training are used.
Also effective are warm sit trays with decoctions of chamomile or sage and the addition of 1-2% novocaine.
Etiology of the disease and features of therapy
The most common causes of the inflammatory process are: intestinal and Pseudomonas aeruginosa, staphylo-and enterococci, Klebsiella, Proteus, less often Chlamydia and Ureaplasma.
In the overwhelming number of cases, a mixed (mixed) infection associated with both anaerobic and aerobic pathogens is isolated from the prostate secretion obtained after the massage. The most common component of such microbial associations are staphylococcus.
The combination of pathogens complicates the process of treatment and leads to the mutual enhancement of inflammatory properties and drug resistance of the pathogenic flora.
That is why, in such a situation, it is preferable to use a combined antibacterial treatment.
Also, it is important to consider ways of infection of the gland:
- hematogenous (in the presence of a remote purulent-septic focus),
- lymphogenous (infection of the rectum),
- canalicular (penetration of infection from the back of the urethra).