Treatment of prostatitis with antibiotics – when without themnot enough?

Update: November 2018

Prostatitis is a disease that men most often suffer from.
middle age when for various reasons occurs
inflammation of the prostate gland. Depending on the flow,
disease duration, causes, individual
the sensitivity of a man by a doctor according to indications
individual treatment of prostatitis with antibiotics. Since in a number
cases without antibiotic therapy is indispensable.

When is antibiotic treatment indicated?

Prostatitis is classified into two groups – bacterial
(infectious) and non-bacterial. Moreover, for the treatment of the latter
shows the use of antimicrobial agents. Antibiotics же
necessary for acute and chronic bacterial prostatitis, even
asymptomatic, as well as trial therapy for
non-infectious nature of the occurrence of prostatitis, as
test therapy. To determine the need for treatment of prostatitis
antibiotics, the doctor must adhere to the following scheme
examinations to determine the true cause and pathogen
diseases:

Read also on the topic:

  • Candles for prostatitis with propolis
  • Symptoms and causes of prostatitis
  • Prostatitis treatment
  • Prostate cancer
  • Prostate adenoma
  • Causes of Frequent Urination in Men
  • 11 rules – How to take antibiotics correctly

Stage 1 survey

  • Clinical blood test
  • Urinalysis (three glass test)
  • Urine culture
  • PCR of the urethra epithelium (scraping) for infections of genital infections
    (chlamydia, gonococcus, mycoplasma, Trichomonas, etc.)
  • Analysis of prostatic secretion
  • Prostate ultrasound
  • Blood PSA (differential diagnosis with prostate cancer)

Stage 2 survey

If the leukocytes are in the secret of the prostate below 25, then spend
Omnick (tamsulosin) drug therapy for a week, then
re-analysis of the secret.

The survey results determine the type of disease

Non-infectious prostatitis

According to the test result, if the white blood cells do not increase, all the crops
will be negative, then prostatitis is defined as non-infectious.
It is also called chronic pelvic pain syndrome and is carried out
only symptomatic treatment. However, the results of sowing on
tuberculosis has to wait 10-12 weeks, and in the case of
positive tests, the patient is sent for treatment in
Urology Department of TB Dispensary.

Prostate tuberculosis

The diagnosis is made on the basis of prostate biopsy (study
punctate gland). It is rarely isolated because more often
combined with damage to the urinary tract, epididymis,
seminal vesicles.  Often, diagnostics in Russia is
diseases is difficult, and in fact tuberculosis in recent years begins
to become epidemic, with any localization and with
drug-resistant forms.

The cunning of urogenital tuberculosis in men lies in
that very rarely this disease develops acutely, most often
it is a chronic disease with periods of remission and exacerbations, and
even crops for tuberculosis sometimes give false negatives
results, especially when taking fluoroquinolones active in
against mycobacterium tuberculosis.

Complaints of a patient with prostate tuberculosis may be associated with
symptoms of general intoxication – subfebrile temperature,
weakness, rarely a man may experience aching or burning pain in
perineum, anus, sacrum. The disease is more common in
middle-aged men 20–40 years old, with the highest functional
prostate activity.

Bacterial, infectious prostatitis

If at the first analysis the number of leukocytes exceeds 25 or they
will increase after taking Omnik, then prostatitis is attributed to
bacterial or latently infectious. In this case, the treatment
antibiotics needed.

Since PCR diagnostics for major genital pathogens
infections is carried out within a day from the time of treatment (more often
just at the first admission is taken scraping the epithelium of the urethra),
антибиотики prescribeся через сутки от первого обращения. Wherein
A drug is selected, to which pathogens are most sensitive.
Otherwise, a broad spectrum antibiotic is selected.
actions.

При нечувствительности флоры (отсутствии результата
treatments) wait for the result of the bakposeva with the definition
чувствительности к антибиотикам и prescribe препараты более
sighting 

What are the most effective antibiotics for prostate?

We can not say that there is some better antibiotic
prostatitis because any antimicrobial therapy should
based on the individual sensitivity of the bacteria in each
specific case.

You can not engage in self-diagnosis and self-treatment.
antibacterial and other drugs. Selection
The drug depends on the identified pathogen, as well as its
antibiotic resistance or sensitivity. Duration
the course, the dosage is selected only by a doctor taking into account the severity
process (chronic or acute), most often used
антибиотики широкого спектра actions.

If specific infections are not detected, drugs prescribe
based on seeding prostatic secretion (more often it is
non-specific staphylococci or streptococci).

On average, a course prescribed by a doctor is 1-2 months, and
treatment of chronic prostatitis with antibiotics must
be combined with other medical procedures and
drugs, namely:

  • Antibiotics
  • Nonsteroidal anti-inflammatory drugs
  • Preparations that normalize blood circulation
  • Vitamin therapy
  • Immunostimulating drugs
  • Phytotherapy
  • Massage of the prostate gland, manual massage, heat
    microwave therapy – shown only after exclusion
    tuberculosis, since both massage and heat exposure lead to
    a dramatic exacerbation of the tuberculous process in which these
    procedures are strictly contraindicated.
  • Sedatives and antidepressants – Antidepressants and
    Sedatics are used in patients with severe chronic forms.
    prostatitis causing depressive disorders and interfering
    man to live normally and qualitatively. This means not the first
    lines, not etiotropic drugs, but in the treatment of prostatitis
    used as ancillary drugs.

The main groups of antibiotics used to treat
prostatitis, taking into account generally accepted sensitivity information
The main pathogens of bacterial prostatitis are presented in
table:

tetracycline penicillin cephalosporin macrolide fluoroquinolone
Ureaplasma + +  +
Mycoplasma  +  +  +
Chlamydia  +  + +
Gonococci +  +  +  +
Enterobacteria +  +  +
Enterococci  +  +
Klebsiella  +  + +  +
Protei + + +
Seratia  +  +
Pseudomanada  +
Klebsiella  +  +  +  +
E. coli + + +  +
Koch’s wand – tuberculosis +

In addition to these pathogens, the inflammatory
process in the prostate gland or urinary system,
fungal agents may influence. Therefore, the application of a new
combined drug safocid containing and preparation for
treatment of thrush fluconazole, and secnidazole, and azithromycin may
be appointed by a doctor according to indications. Its use is recommended.
with uncomplicated urinary infections and for the treatment of
bacterial prostatitis.

The list of groups of antimicrobials used in
treatment of prostatitis

  • Fluoroquinolones are by far the most highly effective.
    drugs especially for the treatment of chronic bacterial
    prostatitis, but in addition to other side effects of all antibiotics,
    they have neurotoxicity and phototoxicity. И их
    apply only after exclusion of tuberculosis etiology
    inflammatory process.
    Fluoroquinolones are included in
    comprehensive treatment of all forms of tuberculosis, and in case the patient
    находится в ожидании результата посева на туберкулез, fluoroquinoloneы
    can not be used. Treatment of tuberculosis involves taking as
    at least 4 anti-TB drugs, and therapy with only one
    antibiotic causes drug resistance mycobacteria
    tuberculosis to this antibiotic and further leads to
    chronic, not treatable urogenital tuberculosis
    system, which is extremely dangerous. If a man is on reception
    fluoroquinoloneов наступает значительное улучшение, а после отмены
    drug in 1-2 months again relapses, should
    go to the tuberculosis dispensary for a more thorough
    screening, tuberculin tests and resubmit
    analyzes.Лечение простатита антибиотиками Trade names
    fluoroquinoloneов:
  • Таваник, Элефлокс,  — левофлоксацин
  • Tsiprinol, Tsiprobay – ciprofloxacin
  • Цифран  — ципрофлоксацин
  • Офлоксин, Заноцин  — офлоксацин
  • Tetracyclines – their use in recent times significantly
    decreased, it is possible to use only Doxycilin, which
    relatively better tolerated than other antibiotics
    tetracyclineового ряда — торговое название Юнидокс Солютаб.
  • Penicillins – is now widely used combined
    Amoxicillin with clavulanic acid, which has more
    strong antibacterial action – trade name Amoxiclav,
    Флемоксина солютаб, Аугментин,  Флемоклав солютаб.
  • Cephalosporins – preparations for intramuscular administration,
    торговые названия —  Кефадим, Клафоран, Цефспан, Супракс,
    Ceftriaxone, cefotaxime and others.
  • Macrolides – they are not used often, because there are no studies
    confirming the appropriateness of their use for prostatitis,
    however, they are slightly toxic and very active against a number of bacteria,
    especially chlamydia and mycoplasma. Trade names антибиотиков этой
    groups: azithromycin (Zitrolid, Sumamed), clarithromycin
    (Fromilid).

When choosing an antibiotic for prostatitis, it should be borne in mind that
few are able to accumulate at the right concentration in
prostate tissue, which is very important for prostatitis. therefore
использование macrolideов, fluoroquinoloneов, аминогликозидов
(Gentamicin) is preferred, as well as in acute
bacterial prostatitis can be prescribed simultaneously two
antibacterial agents for faster removal of acute
inflammation.

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