Symptoms, treatment and causes of bacterial prostatitis. Treatment regimen for prostatitis with antibiotics Treatment methods for congestive prostatitis

The term prostatitis means a disease of the prostate gland of inflammatory and infectious origin, isolated or combined with damage to the seminal vesicles and tubercle, as well as the urethra (its posterior part).

The disease can occur in acute (usually occurs between 30 and 50 years) and chronic forms.

Chronic prostatitis develops as a result of stagnant processes in the gland or may be a consequence of an untreated acute disease. It is characterized by slow development and scar-sclerotic changes in the organ tissue. It is important not to confuse it with benign prostatic hyperplasia (adenoma), an age-related involution that occurs as a result of the growth of the periurethral gland and causes obstruction of the urinary tract.

The goal of treatment will be to eliminate clinical symptoms and reduce the risk of complications, as well as complete restoration of copulatory function and fertility. Antibiotics for prostatitis and adenoma are prescribed to eliminate the etiological bacterial factor. Antimicrobial therapy for adenoma is also used in case of planned hospitalization in a surgical hospital, in order to prevent postoperative infectious and inflammatory complications.

The main symptoms of prostatitis will be:

• not sharp, aching, nagging pain in the perineum, radiating to the rectum, testicles, glans penis, sacrum, and rarely to the lower back;
• dysuric disorders, especially in the morning, constant feeling of incomplete emptying of the bladder;
• discharge of small secretions after urination;
• increased pain during prolonged sitting and decreased pain after walking;
• erectile disorders, premature ejaculation, impotence;
• general condition disturbance, nervousness, decreased performance, insomnia.

When confirming the diagnosis, they rely on the results of a digital examination, indicators of a general blood and urine test, prostate secretions, a 2-glass test after a massage, spermogram, hormonal profile, and ultrasound. If necessary, differential To diagnose an adenoma, a biopsy is performed.

Drugs of choice or best antibiotics for prostatitis in men

The gold standard of treatment is fluoroquinolones.

Ciprofloxacin ® (Cifran ®, Cifran OD ®, Ciprobay ®, etc.)

An antibacterial agent with a wide spectrum of antimicrobial effects, which is due to its ability to inhibit DNA gyrase of pathogenic microorganisms, disrupting the synthesis of bacteria. DNA and leading to irreversible changes in the microbial wall and cell death.

Ciprofloxacin ® has no effect on Ureaplasma, Treponema and Clostridium difficile.

Antibiotic is contraindicated:

• up to eighteen years of age;
• in the presence of colitis caused by taking antimicrobial agents in the anamnesis;
• in case of individual hypersensitivity to fluoroquinolones;
• patients with porphyria, severe renal and liver failure;
• simultaneously with Tizanidine ® ;
• epileptics and persons with severe damage to the central nervous system;
• in case of cerebrovascular accident;
• in patients with tendon damage associated with fluoroquinolones.

Features of the use of Ciprofloxacin ®

To reduce the risk of adverse events, it is recommended during therapy:

• avoid physical activity and excessive sun exposure;
• use creams with high SPF;
• increase your drinking regime.

Ciprofloxacin ® is not combined with non-steroidal anti-inflammatory drugs due to the high risk of developing seizures. It can also enhance the toxic effect of Cyclosporine ® on the kidneys.

When combined with Tizanidine ®, a sharp drop in blood pressure, even collapse, is possible.

Use during anticoagulant therapy may cause bleeding. Strengthens the effect of glucose-lowering tablets, increasing the risk of hypoglycemia.

When combined with glucocorticosteroids, the toxic effect of fluoroquinolones on tendons increases.

In combination with beta-lactams, aminoglycosides, metronidazole and clindamycin, a synergistic interaction is observed.

Undesirable effects from treatment

• disruption of the gastrointestinal tract;
• neuroses, anxiety, hallucinations, nightmares, depression;
• tendon ruptures, arthralgia, myalgia;
• arrhythmias;
• perversion of taste, decreased sense of smell, impaired visual acuity;
• nephritis, renal dysfunction, crystalluria, hematuria;
• cholestatic jaundice, hepatitis, hyperbilirubinemia;
• decreased number of platelets, leukocytes, hemolytic anemia;
• photosensitivity;
• hearing loss (reversible);
• lowering blood pressure;
• colitis and diarrhea.

Calculation of 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 severe forms 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. The standard course of therapy ranges from ten to 28 days.

How to treat bacterial prostatitis (acute and chronic) in men with antibiotics?

To eradicate the pathogen and eliminate the inflammatory process, broad-spectrum drugs are used that work against the most common pathogens.

I) Fluoroquinolones:

• Norfloxacin ® (Nolitsin ®, Norbactin ®);
• Ciprofloxacin ® (Ciprolet ® , Tsiprobay ® , Tsifran OD ® , Tsiprinol ® , Quintor ® , Quipro ® );
• Levofloxcin ® (Tavanic ® , Glevo ® , Levolet R ® );
• Ofloxacin ® (Tarivid ®, Zanonin OD ®);
• Moxifloxacin ® (Avelox ®).

II) Fluoroquinolones in combination (the best antibiotics for prostatitis caused by mixed infections):

• Ofloxacin ® + Ornidazole ® (Ofor ® , Polymik ® , Combiflox ® );
• Ciprofloxacin ® + Tinidazole ® (Cifran ST ®, Ciprolet A ®, Ciprotin ®, Zoxan TZ ®);
• Ciprofloxacin ® + Ornidazole ® (Orcipol ®).

III) Cephalosporins:

• Cefaclor ® (Vercef ®);
• Cefuroxime-axetil ® (Zinnat ®);
• (Cephabol ®);
• Ceftriaxone ® (Rofecin ®);
• Cefoperazone ® (Medocef ®, Cephobit ®);
• (Fortum ®);
• Cefoperazone/sulbactam ® (Sulperazone ® , Sulzoncef ® , Bakperazone ® , Sulcef ® );
• Cefixime ® (Suprax ® , Sorceph);
• Ceftibuten ® (Cedex ®).

IV) Inhibitor-protected penicillins (Axicillin/Clavulanic acid ®):

• Augmentin ®;
• Amoxiclav ® ;
• Ranklav ® ;
• Panclave ® .

The drug is not prescribed:

• persons with individual hypersensitivity to macrolides;
• severe kidney and liver diseases;
• against the background of the use of ergotamine and dihydroergotamine;
• for severe arrhythmias.

Use with caution in patients with myasthenia gravis, heart failure, hypokalemia and hypomagnesemia, mild to moderate renal and hepatic impairment.

Side effect of the drug

Possible disorders of the gastrointestinal tract of a dyspeptic nature, a transient increase in liver transaminases, jaundice, dysbacteriosis, fungal infection of the mucous membranes, insomnia, headaches, allergic reactions, photosensitivity.

Drug combinations

Alcohol, food and antacids reduce the bioavailability of Sumamed ®. Prescription is not recommended for persons receiving anticoagulants. Does not combine well with oral hypoglycemic agents, there is a risk of hypoglycemia. Exhibits antagonistic interaction with lincosamides and synergistic interaction with Tetracycline ® . Has farm. incompatibility with heparin.

Effective treatment of bacterial prostatitis largely depends on how the disease is classified (acute or chronic) and what type of infectious agent it is.

This is determined by the diagnosis of the disease: the symptoms of the disease, possible causes, etc. are determined.

Treatment of bacterial prostatitis can be medicinal or non-medicinal.

Drug treatment of bacterial prostatitis can be presented as follows:

• taking antibiotics;
• taking alpha blockers if you have problems urinating. These drugs help relax the smooth muscle cells in the walls of the bladder and urethra, which normalizes the process of urination;
• taking nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve pain caused by inflammation in the prostate gland. You may be prescribed drugs from the Diclofenac or Ibuprofen group;
• If during treatment a man experiences mood swings or the development of depression, then additional sedatives are prescribed.

Non-drug treatments for bacterial prostatitis include:

• folk remedies (usually herbal treatment);
• organization of proper nutrition (special diets);
• physiotherapy.

Disease prevention plays an important role.

Folk remedies for treating bacteria in prostatitis: choosing the right diet, doing physical therapy, prescribing prophylaxis

Treatment at home:

• Pumpkin seeds are extremely effective. It is enough to take 30 seeds per day. The beneficial effect is explained by the fact that pumpkin seeds contain a large amount of zinc, which helps treat prostatitis.
• Vegetable juice made at home. It is extremely useful to use asparagus. Beets, carrots and cucumbers will also be useful. You need to drink about 50 grams of this freshly squeezed juice per day.
• A decoction of chestnut shells is beneficial. This decoction should replace tea and drink it throughout the day.

Physiotherapy

Physiotherapy is prescribed only in two cases: 1 - the man has recovered, 2 - the chronic process has worsened.

If you have prostatitis, self-medication is unacceptable.

After examining the patient, the doctor may prescribe the following types of physical therapy:

• prostate massage;
• magnetic therapy;
• UHF therapy;
• laser therapy;
• hirudotherapy.

Diet

When organizing proper nutrition, it is strictly forbidden to include the following products in your diet:

• Coffee and carbonated drinks.
• Juices in tetra packs.
• Alcoholic drinks.
• Products for instant preparation.
• Canned foods.
• Semi-finished products.
• Fatty, spicy, smoked and pickled foods.

If bacterial prostatitis is not treated correctly (or not treated), the following complications are possible:

• The development of blood clots in the vessels that supply the prostate with blood.
• Formation of stones in the prostate.
• Manifestation of purulent abscesses in the prostate.
• Development of prostate adenoma.
• Formation of benign prostatic hyperplasia.
• Development of erectile dysfunction.
• Formation of tumors in the prostate gland (prostate cancer).

Proper prevention of bacterial prostatitis will help reduce the risk of developing the disease, namely:

• Proper nutrition, which consists of organizing a suitable diet: healthy foods and observing meal times.
• Regular sexual intercourse.
• Active lifestyle.
• Proper clothing so as not to overheat or overcool the body.
• Give up all bad habits: stop drinking alcohol and smoking.

Treatment of chronic bacterial prostatitis is a long and complex process, since the infection persists in the prostate for a long time. Even in cases where the symptoms of the disease have disappeared, it is necessary to take a full course of antibiotics, since the infection can persist without symptoms. To treat chronic bacterial prostatitis, it is necessary to identify the type of infection in order to select a suitable drug to which the pathogen is hypersensitive.

Acute bacterial prostatitis manifests itself through severe fever. Chills and pain in the lower abdomen appear suddenly, and urination is difficult. Treatment consists of timely administration of antibiotics.

If acute bacterial prostatitis is not treated, it will take a chronic form.

Antibacterial drugs for prostatitis: which is better to choose

Antibacterial drugs for prostatitis are the main medical treatment for bacterial prostatitis.

Treatment of bacterial prostatitis with antibiotics and antimicrobial agents can be carried out by taking drugs from the following groups:

• protected penicillins;
• macrolides;
• tetracyclines;
• cephalosporins;
• fluoroquinols.

You can make your own suppositories to treat bacterial prostatitis. Propolis is perfect for this. It is necessary to evaporate 40 grams of propolis in a glass of alcohol. Then mix 0.1 g of extract with 2 g of cocoa butter. Small candles are made from the resulting mixture. At night, such a suppository should be inserted into the rectum. The procedure should be carried out within a month.

Treatment of bacterial prostatitis with antibiotics: list of drugs and treatment regimen

Currently, bacterial prostatitis is treated with antibiotics as follows:

• group of aminoglycosides: taking Gentamicin, Kanamycin, 5-NOK;
• group of cephalosporins: prescription of Ceftriaxone;
• penicillin group: taking Amoxiclav;
• group of tetracyclines: taking Doxycycline or Tetracycline;
• group of macrolides: prescription of Azithromycin, Sumamed, Clarithromycin, Oleandomycin;
• group of fluoroquinolones: taking Norfloxacin, Ciprofloxacin, Ofloxacin. Fluoroquinolones have a lower ability to penetrate prostate tissue, however, these drugs are prescribed if other antibiotics are contraindicated in the male body.

Treatment regimen for bacterial prostatitis

A man must be examined to identify the type of pathogen (sensitivity of microorganisms to drugs of a particular group) and prescribe the necessary antibiotic. This analysis is carried out by examining prostate juice.

Antibiotics for the treatment of bacterial prostatitis must be taken for an average of two weeks. Then the prostate juice is analyzed again. If the pathogen is detected again, the antibiotics may be extended for a week or replaced with a different type of medication. If treatment is carried out in a timely manner and with correctly selected antibiotics, then prostatitis will be completely cured. Otherwise, the disease may become chronic.

Good pharmacokinetics, high concentration in prostate tissue, good bioavailability. Equivalent pharmacokinetics for oral and parenteral administration (for ciprofloxacin, ofloxacin, levofloxacin, sparfloxacin). Ciprofloxacin and ofloxacin have a prolonged release form - OD tablets, which allow the active substance to be released evenly throughout the day and thereby maintain an equilibrium concentration of the drug. Levofloxacin (Floracid), ciprofloxacin, sparfloxacin (especially in association with intracellular sexually transmitted infections), and, to a lesser extent, norfloxacin should be considered optimal for prostatitis.

All fluoroquinolones showed high activity against typical and atypical pathogens, including Pseudomonas aeruginosa. Disadvantages include photo- and neurotoxicity. In general, fluoroquinolones can be considered as first-line drugs in the treatment of patients with chronic prostatitis, but only after excluding tuberculosis.

• levofloxacin (tavanic, floracid, eleflox) 500 mg/day;
• ciprofloxacin (tsiprobay, tsiprinol) 500 mg/day;
• ciprofloxacin (Tsifran OD) 1,000 mg/day;
• ofloxacin (zanocin OD, ofloxin) 800 mg/day;
• sparfloxacin (Sparflo) 200 mg twice a day.

Trimethoprim

Penetrates well into the prostate parenchyma. Along with tablets, there is a form of the drug for intravenous administration. In modern conditions, the low cost of trimethoprim can be considered as an advantage. However, although the drug is active against the most important pathogens, it does not act on Pseudomonas spp., some enterococci and some representatives of the genus Enterobacteriaceae, which limits the use of this medicine in patients with chronic prostatitis. Trimethoprim is available in combination with sulfamethoxazole (400 or 800 mg of sulfamethoxazole + 80 or 160 mg of trimethoprim; respectively, the combined drug tablet contains 480 or 960 mg of the active substance).

• co-trimaxazole (Biseptol 480) 2 tablets twice a day.

Tetracyclines

Also available in two forms of administration, they are highly active against chlamydia and mycoplasma, so their effectiveness is higher in chronic prostatitis associated with sexually transmitted diseases. The optimal option is doxycycline (Unidox Solutab), which has the best pharmacokinetic data and tolerability.

• doxycycline (Unidox Solutab) - 200 mg/day.

Macrolides

Macrolides (including azalides) should be used only under certain conditions, since there are only a small number of scientific studies confirming their effectiveness for prostatitis, and this group of antibiotics has little activity against gram-negative bacteria. But you should not completely abandon the use of macrolides, since they are quite active against gram-positive bacteria and chlamydia; accumulate in the prostate parenchyma in high concentrations and are relatively non-toxic. The optimal drugs in this group are clarithromycin (Fromilid) and azithromycin. Recommended doses:

• azithromycin (sumamed, zitrolide) 1000 mg/day for the first 1-3 days of treatment (depending on the severity of the disease), then 500 mg/day;
• clarithromycin (fromilid) 500-750 mg twice a day.

Other drugs

The combined drug safocid can be recommended. Its uniqueness lies in the fact that it contains a complete combined one-day course of treatment in one blister (4 tablets): 1 tab. fluconazole (150 mg), 1 tablet of azithromycin (1.0 g) and 2 tablets of secnidazole A 1.0 g each. This combination, taken simultaneously, can achieve a bactericidal effect against Trichomonas vaginalis, gram-positive and gram-negative anaerobes, including Gardnerella vaginalis (secnidazole), against Chl trachomatis, Mycoplasma genitalium, gram-positive and gram-negative microflora (azithromycin), as well as against fungi of the genus Candida (fluconazole).

Thus, safocid meets all WHO requirements for drugs used for the treatment of sexually transmitted infections, including the treatment of chronic prostatitis: effectiveness of at least 95%, low toxicity and good tolerability, single dose, oral administration, slow development of resistance to the therapy being carried out.

Indications for taking safocid: combined uncomplicated sexually transmitted infections of the genitourinary tract, such as gonorrhea, trichomoniasis, chlamydia and fungal infections, accompanied by specific cystitis, urethritis, vulvovaginitis and cervicitis.

For an acute uncomplicated disease, a single dose of the safocid complex is sufficient; for a chronic process, the full set must be taken for 5 days.

European recommendations for the management of patients with infections of the kidneys, urinary tract and male genital organs, compiled by a team of authors led by Naber K.G., insist that for bacterial chronic prostatitis, as well as for chronic prostatitis with signs of inflammation (categories II and III A), antibiotics should be used prescribe for 2 weeks after the initial diagnosis is established. The patient's condition is then re-evaluated and antibiotic therapy is continued only if the pre-treatment culture is positive or if the patient shows marked improvement with antibiotic treatment. The recommended total duration of treatment is 4-6 weeks. Oral therapy is preferred, but doses of antibiotics must be high.

The effectiveness of antibiotics in the so-called inflammatory syndrome of chronic pelvic pain (what we consider as latent chronic prostatitis) by the authors of the manual, citing studies by Krieger J.N. et al. is also explained by the likely presence of bacterial microflora not detected by conventional diagnostic methods.

Here are several options for basic treatment of patients with acute prostatitis CIP and latent CIP.

Treatment regimen for acute prostatitis

• ceftriaxone 1.0 g per 200 ml of 0.9% sodium chloride solution intravenously 2 times a day for 5 days, then intramuscularly for 5 days;
• furazidin (Furamag) 100 mg three times a day for 10 days;
• paracetamol (perfalgan) 100 ml intravenously at night every day for 5 days;
• meglumine sodium succinate (Reamberin) 200 ml intravenously every other day, 4 infusions in total;
• tamsulosin 0.4 mg daily;
• other symptomatic therapy - individually according to indications.

Treatment regimen for chronic infectious and latent infectious prostatitis

It is important that the examination algorithm must be followed at the initial appointment. First, a 3-glass urine sample with its bacteriological examination, then a digital rectal examination, obtaining prostate secretion for microscopy and culture. Culture is intended to identify nonspecific microflora and mycobacterium tuberculosis; according to indications - sexually transmitted infections. If less than 25 leukocytes per field of view are detected in the prostate secretion, test therapy with tamsulosin (omnic) should be performed for 5-7 days with repeated massage of the prostate and repeated examination of its secretion. If the number of leukocytes does not increase and cultures are negative, the disease should be classified as non-infectious prostatitis (chronic pelvic pain syndrome) and appropriate pathogenetic and symptomatic therapy should be carried out. If the initial analysis shows more than 25 leukocytes per field of view or their number increases after test therapy, the disease should be considered infectious or latently infectious. In this case, the basis of treatment becomes antibacterial therapy - empirical at the beginning, and corrected after receiving the results of bacteriological examination.

If prostatitis appears, there is a high probability that special treatment will be needed. A bacterial disease develops in a third of patients. It is necessary to suppress the growth of bacteria using suitable medications. Antibiotics for prostatitis are prescribed when the diagnosis is confirmed by preliminary research. In order for treatment to bring the desired effect, acting on the body as carefully as possible, choose the drugs that will best help you, find out how to take them and the potential dangers of using them.

Benefits of Antibiotic Treatment

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 proliferation of bacteria and large viruses, but are safe for the cells of the macroorganism;
• act when applied externally (suppositories, ointments) and with other methods of administration: intramuscular, oral, intravenous;
• fight against many pathogens simultaneously (broad-spectrum antibiotics).

The main groups of antibacterial drugs used for prostatitis

Antibiotics are a relatively new substance, discovered in the 20s of the last century. A large list of drugs neutralizes viruses, helping to remove the causes of prostatitis and other diseases. The different nature of the effect and differences in the chemical structure made it possible to identify several groups of antibiotics for prostatitis of a bacterial nature: chronic or acute.

Fluoroquinolones

Today, fluoroquinolones are synthesized chemically. Active substances that affect different types of bacteria are especially good at treating the chronic form of the disease. Fluoroquinolone-based products are absorbed into the gastrointestinal tract as quickly as possible. From here they easily move inside the cells of organs and tissues and destroy bacteria. Medicines cause gastrointestinal and nervous system disorders, allergies. In rare cases, diseases of the kidneys, musculoskeletal system, heart, candidiasis, and colitis are observed. For prostatitis the following is prescribed:

• "Ofloxacin";
• "Levofloxacin";
• "Ciprofloxacin."

Tetracyclines

The tetracycline family includes broad-spectrum antibiotics that are similar in composition and properties. They have the same mechanism of influence on microbes, similar characteristics and complete cross-resistance. If one drug has stopped working on the body, similar ones will also be ineffective. To achieve results, it is better to take it with drugs that have a different method of operation. Tetracyclines are highly active against bacteria that cause prostatitis, but are difficult to tolerate. Urologists prescribe the following drugs for prostatitis:

• "Doxycycline";
• "Tetracycline".

Penicillins

Penicillins block the synthesis of peptidoglycan, from which the bacterial cell wall is built. Because of this they die. The mammalian body does not produce peptidoglycan, so the drugs are safe for humans; the only thing you might encounter when taking them is an allergy. The most commonly used medications for prostatitis of the penicillin group are tablets:

• "Amoxicillin";
• "Amoxiclav".

Cephalosporins

The bactericidal principle of action of cephalosporins is dangerous for microorganisms. It damages their cell wall and leads to death. The absorption of drugs in this group from the gastrointestinal tract is weak (with the exception of Cephalexin). They irritate mucous membranes, cause allergies, kidney problems, and are contraindicated in cases of meningitis. Used intramuscularly. Recommended antibiotics for prostatitis are:

• "Ceftriaxone";
• "Cefuroxime".

Macrolides

Macrolides are the least toxic antibiotics of natural origin that prevent the growth of bacteria. These drugs are rarely used because their effectiveness has not been proven. Patients tolerate therapy with these drugs for prostatitis well. The drugs rarely cause allergies; there are no cases of liver or kidney depression, destruction of joints, bone tissue, or toxic effects. Antibiotics for infectious prostatitis:

• "Josamycin";
• "Azithromycin" ("Sumamed");
• "Wilprafen".

Antibiotic regimen for the treatment of prostatitis in men

To effectively cure a disease, it is necessary to carry out a diagnosis that will show the type of bacteria that cause the disease in a particular patient and their sensitivity to medications. Based on the test results, the doctor decides what means to treat chronic prostatitis or the acute form of the disease. A set of procedures will help relieve inflammation of the prostate gland if the disease is caused by bacteria. The treatment regimen for prostatitis includes:

• taking antibiotics to eliminate bacteria;
• the use of medications to improve blood circulation and reduce congestion (“Pentoxifylline” tablets);
• adding anti-inflammatory drugs - if you need to relieve pain by reducing swelling of the gland (non-steroidal Diclofenac, Meloxicam, Nimesulide or hormonal Prednisolone, Prednisone, Solumedrol);
• substances that regulate the immune system (“Tactivin”, “Timalin”, “Levamisol”);
• vitamins A, B6, E, C;
• trace elements: selenium, zinc, magnesium;
• sedatives (“Afobazol”, “Miaser”);
• herbs (lingonberry, elderberry, St. John's wort, comfrey, goldenrod);
• prostate massage – it relieves inflammation and gets rid of stagnant secretions;
• physical exercise stimulates blood circulation.

In acute form of pathology

Treatment is carried out in a hospital or under medical supervision at home. They use medications that have a complex effect: cephalosporins (Ceftriaxone, Cefotaxime), tetracyclines (Rondomycin, Tetracycline), and to reduce inflammation - fluoroquinolones (Levofloxacin, Ofloxacin). For a quick effect, the urologist may prescribe two antibiotics.

The result of therapy for acute inflammation is usually visible immediately, but it is absolutely impossible to stop taking the drugs. Complete the 4-week course and strictly follow the dosages to prevent the inflammatory process. Otherwise, it can transform into a chronic form. If you strictly follow all the recommendations of the urologist, the disease will recede forever and will not return.

For chronic prostatitis

Sluggish chronic course of prostate disease is observed much more often. Periods of calm are followed by exacerbations. Is chronic prostatitis curable? The prognosis is less comforting than in the case of acute inflammation. The results of therapy are weaker: the pathology changes the structure of the gland tissue so that the antibiotic does not stay in them for long. Destination:

1. The drugs are prescribed taking into account the nature and degree of sensitivity of the microflora.
2. Broad-spectrum medications are highly effective, especially cephalosparins (Ceftriaxone) and macrolides (Roxithromycin, Vilprafen, Azithromycin), fluoroquinolones (Norfloxacin, Ofloxacin).
3. The minimum course is a month, however, several cycles are often carried out with breaks. You cannot stop treatment when your condition improves: changes can be deceptive.

What antibiotics are the most effective?

To cure or reduce the symptoms of infectious prostatitis, strictly follow your doctor's recommendations. Start the course only after the diagnosis has been carried out, when the doctor understands the nature of the disease. Self-treatment at home is fraught with devastating consequences and disruptions in the functioning of body systems. The table provides a list and dosages of popular antibiotics for prostatitis:

Are there any side effects and contraindications?

Often, along with medications, compounds that restore the gastric microflora are prescribed. The following possible reactions to antibiotics are noted:

• gastrointestinal tract malfunctions;
• allergic rashes;
• intoxication (fever, pain, diarrhea);
• deterioration of health.

Antibiotics are not used to treat non-infectious (congestive) inflammation. It is prohibited to accept them:

• for allergies;
• kidney and liver disorders;
• pregnancy;
• breastfeeding;
• children.

Each person’s body contains various microorganisms that do not cause any harm to health. But under the influence of certain factors, previously harmless bacteria become the cause of various pathologies.

One of these diseases is infectious inflammation of the prostate gland.

This pathology is considered the most common male disease, and causes not only physical, but also moral discomfort.

Causes and principle of development of the disease

Some of the bacteria present in the body inhabit the human intestines, the other part is located on the skin. But often microorganisms enter through the urethra into the prostate gland, the secretions of which are normally sterile.

At the same time, the composition of the secretion of this male organ has ideal conditions for the life of microbes, which is why bacteria that have entered the gland begin to actively multiply.

The immune system, reacting to the presence of microorganisms, sends leukocytes to eliminate them. The result of this process is infectious prostatitis.

What bacteria cause inflammation:

• coli. Causes an illness of the male organ in 70-80% of cases;
• streptococcus;
• staphylococcus;
• enterococcus;
• Trichomonas;
• chlamydia;
• Proteus;
• Klebsiela

Infection and prostatitis-causing bacteria enter the gland under the influence of the following factors:

• the presence of phimosis of this male organ;
• engaging in unprotected sexual intercourse (during anal sex, the risk of pathogenic microorganisms increases several times);
• development of acute epidymitis;
• carrying out transurethral interventions without previous prescription of an antibacterial drug;
• catheterization of the bladder performed in violation of the rules;
• the presence of pathologies of the bladder neck that cause disruption of the urination process;
• decreased immune defense, including those caused by diseases such as diabetes, AIDS or HIV;
• narrowing of the urinary canal;
• the occurrence of problems with urinary function due to the development of prostate adenoma.
• the presence of infections in the urinary tract, for prostatitis is one of the main reasons for its development;
• the occurrence of hormonal dysfunction;
• presence of sexually transmitted diseases;

There are also risk groups for developing bacterial inflammatory disease of the prostate, including people who:

1. They have bad habits - smoking, drinking alcohol.
2. They lead a sedentary lifestyle.
3. Have promiscuity or irregular sex.
4. They experience stress.
5. We have passed the 50-year mark. Often, older people develop hyperplasia of the male gland, causing the growth of its tissues, as a result of which the release of secretions becomes much more difficult. Stagnation of fluid promotes the proliferation of microbes.

Infectious inflammatory process of the prostate is a non-contagious disease that is not sexually transmitted.

However, if the disease is caused by a microorganism such as trichomonas or chlamydia, then they can be transmitted to a sexual partner.

Types of infectious inflammatory process

There are two types of bacterial prostatitis in men:

1. Infectious prostatitis in acute form. Has more pronounced and intense symptoms. Acute inflammation has three stages of development: 1. catarrhal; 2. follicular; 3. parenchymal.
2. Chronic infectious inflammation. This type of disease, caused by microorganisms, is diagnosed in 95% of cases of development of pathology of the male gland. Chronic viral prostatitis has less pronounced symptoms, but they can cause quite severe discomfort in men. Most often, CKD arises from an acute form against the background of ineffective therapy or due to a complete lack of treatment.

Symptoms

For acute and chronic bacterial prostatitis, both treatment and symptoms differ slightly. In the acute course of bacterial prostatitis, the symptoms are quite intense, occurring suddenly and causing severe pain.

Symptoms of acute bacterial inflammation of the gland:

• an increase in general body temperature to 38 degrees, accompanied by chills;
• pain in the perineum, which can radiate to the groin, tailbone, head of the genitals, and lower back. the pain is nagging or aching in nature;
• problems with urination occur, the stream becomes intermittent, a constant feeling of fullness of the bladder appears, which is why the urge to urinate becomes more frequent. such changes are a sign of compression of the urethra by an enlarged prostate;
• feeling of weakness and fatigue, muscle pain;
• burning of the urethra, occurring due to a large number of microbes and their waste products.

Acute infectious prostatitis has a certain sequence of symptoms depending on the stage of development:

1. During the catarrhal stage, the prostate ducts are affected. Pain appears in the perineal area, which can radiate to the sacrum. Urination may also become more frequent and pain may occur;
2. At the follicular stage, the inflammatory process of the gland lobules begins. The pain becomes stronger and begins to radiate to the anus. Urination becomes difficult, body temperature rises to 38 degrees;
3. At the parenchymal stage, infectious prostatitis affects the entire organ. Body temperature reaches 40 degrees. Severe pain occurs in the perineum, and constipation may occur.

The chronic type of disease, caused by bacteria, has less pronounced symptoms, which may periodically disappear altogether. This is because the infection may subside for a while and then return with renewed vigor.

Chronic bacterial prostatitis has the following symptoms:

• pain when urinating;
• the occurrence of pain in the groin area;
• decreased erection;
• the appearance of pain during sex;
• rapid ejaculation, during which pain occurs;
• blood may be present in the semen.

Taken together, these signs can cause nervous disorders - irritability, apathy, and loss of interest in life.

Diagnostics

Before starting treatment for bacterial prostatitis, you need to visit a specialist to determine an accurate diagnosis.

The urologist will question the patient about the presence of any complaints and perform an examination. If the symptoms indicate chronic bacterial prostatitis, the specialist will perform rectal palpation of the problem organ through the anus. This diagnostic method also allows you to detect the area of ​​​​localization of pathogenic microorganisms.

For signs and complaints indicating chronic bacterial prostatitis occurring in an acute form, as well as for hyperthermia, rectal palpation is contraindicated. Since there is a risk of pathogenic microorganisms spreading through the blood, which will cause serious complications.

After the examination, the specialist will write out directions for tests:

1. Study of prostate secretion.
2. General urine and blood tests.
3. PSA blood test (to detect cancer).
4. Carrying out a spermogram.
5. Analysis of urethral scraping.

• transrectal ultrasound of the prostate;
• CT scan;
• urography;

After receiving all the research results, the attending physician makes a diagnosis and prescribes effective therapy.

Treatment

Treatment of infectious prostatitis, regardless of its form, includes taking antibiotics. A bactericidal drug can only be prescribed by a specialist, based on the type of microorganisms that caused the disease.

Uncontrolled use of antibiotics is highly discouraged due to possible side effects, allergic reactions and lack of effectiveness.

More often than others, antibacterial agents belonging to the group of fluoroquinolones are prescribed. These drugs have a broad effect, are effective against most microorganisms, and have a minimum of side effects.

It is also possible to prescribe medications belonging to the group of tetracyclines, penicillins, cephalosporins and macrolides. Doctors often prescribe simultaneous administration of several groups, which increases the effectiveness of therapy.

To treat inflammation of the gland in men, medications, in addition to antibiotics, include adrenergic blockers and inhibitors that help get rid of the manifestations of the disease in the genitourinary system. Medicines are also prescribed to improve microcirculation in the problem area, which helps reduce inflammation and relieve swelling.

Complex therapy for the disease includes taking medications that increase immunity, with the help of which inflammation can be cured much faster.

Treatment of chronic bacterial inflammation of the gland includes physiotherapeutic methods:

• massage;
• electrophoresis;
• magnetotherapy.

In acute inflammation, due to the risk of spreading infection, thermal manipulation, massage of the problem area, and the use of androgens are prohibited.

Diet for prostate disease

Urologists, when asked how to treat inflammation of the male gland, recommend not only drug therapy, but also adherence to a special diet.

It is necessary to completely eliminate the consumption of alcohol, fatty, spicy and smoked foods, carbonated and energy drinks. It is worth giving up spices, fatty broths, and minimizing salt intake.

You should include boiled vegetables, lean meat and fish, a large amount of greens, fruits, berries and liquids - herbal teas, fruit drinks.

Traditional medicine for the treatment of prostate inflammation

Chronic bacterial prostatitis is a difficult to treat disease. Often men, disillusioned with traditional medicine, resort to folk recipes:

1. Raw peeled pumpkin seeds, in the amount of 0.5 kg, are crushed and mixed with 200 g. honey The resulting mixture forms balls the size of a walnut. Take one ball twice a day half an hour before meals.
2. Half an hour before meals, drink parsley juice - 3 tbsp. spoon.
3. Honey and onion seeds are mixed in equal proportions. Use 1 teaspoon three times a day.

Possible complications

Men are often embarrassed to contact a urologist if they experience unpleasant symptoms of inflammation.

But it is necessary to understand that such a serious disease can cause serious consequences:

• pathological changes in the bladder;
• cystitis of recurrent form;
• prostate adenoma;
• sepsis;
• abscess;
• infertility;
• prostate cancer;
• impotence.

Prevention

1. To refuse from bad habits.
2. Switch to a healthy diet.
3. Have regular sex life with a regular partner.
4. Avoid hypothermia.
5. Play sports and be physically active.
6. Regularly visit a urologist for preventive examination.

If you identify any signs indicating the development of diseases of the male gland, you should immediately visit a specialist. After all, the earlier treatment is started, the greater the effect will be obtained.

Treatment regimen for prostatitis with antibiotics

Prostatitis is inflammation of the prostate tissue. The prostate gland is an organ in the male body that produces prostate secretion, which is an integral part of sperm, and also plays the role of a valve that closes the exit from the bladder during erection. In addition, the prostate gland contributes to the production of testosterone, which is responsible for masculinity.

Classification

Prostatitis is usually divided into acute and chronic, as well as infectious (bacterial) and non-infectious (abacterial).

The causes of this disease are as follows:

1. STIs, that is, sexually transmitted infections (ureaplasma, chlamydia, gonococcus, Candida fungus, etc.) can penetrate the urethral tissue and damage it.
2. Impaired blood circulation in the pelvis. Congestion, which is observed in the prostate, will lead to it becoming inflamed.
3. Sedentary lifestyle. Office workers, drivers and officials are at risk.
4. Impaired immunity.
5. Regular stress.
6. Hormonal imbalance.
7. Lack of microelements and vitamins in the body.
8. Regular hypothermia.

It cannot be said that if you have frequent stress or are a bus driver, then you will 100% have prostatitis. However, we can say that you are at risk and you should monitor your health more closely.

Treatment of prostatitis

As we can see, there are quite a few reasons why prostatitis develops, and almost all of them are in one way or another caused by various microorganisms (viruses, bacteria, fungi and protozoa).

When we begin to treat prostatitis, we are faced with two very important tasks: to destroy the pathogen and remove inflammation.

It is worth noting that there are quite a few methods for relieving inflammation, ranging from medical procedures to folk remedies. However, in order to overcome the pathogen, only antibiotics can help us, which, by the way, cannot always cope on their own.

This is due to the fact that antibiotics can affect bacteria and protozoa, while the same viruses are completely resistant to them, and there is a special antifungal therapy against fungi.

How to treat prostatitis with antibiotics

Today there are a huge variety of antibacterial drugs and antibiotic treatment regimens for prostatitis, also a huge number. However, we must remember that for successful treatment it is best to determine the type of pathogen. Broad-spectrum antibiotics can also be used, but their effectiveness is much lower than that of antibiotics that are tailored for a specific pathogen.

To determine the type of pathogen, a special analysis is performed. It requires only prostate juice. In addition, another analysis is carried out to check the sensitivity of a particular pathogen to a number of antibiotics. These tests will greatly facilitate treatment in the future. And that is why good doctors do not immediately prescribe drugs to the patient, but prefer to first wait for test results.

Briefly about the forms of the disease

The choice of drug will depend entirely on what form of prostatitis, what stage it is at and what the general condition of the patient is.

There are 2 forms of the disease:

1. Spicy. The symptoms are well expressed. The patient is bothered by incessant itching in the groin area, urination in small portions, painful and difficult. Quite often this can be accompanied by high fever. If you consult a doctor in a timely manner and undergo a course of treatment, the prognosis is a complete recovery.
2. Chronic. The disease is recurrent. Periods of exacerbation are followed by periods of remission. Occurs in situations where acute prostatitis was not treated or its treatment was incorrect. As a rule, the course is very difficult and the prognosis is very unfavorable, up to prostate adenoma or prostate cancer.

Treatment of the acute stage of prostatitis takes only 3-5 weeks. As for the chronic stage, everything is much slower here. The effect of treatment may be noticeable only after a few weeks, and recovery may take six months.

How to choose a drug

Antibiotics have different abilities to penetrate the membrane of an organ and accumulate in this organ in order to achieve an effective concentration. That is why, before starting treatment, it is so important to first conduct an analysis of the sensitivity of a particular pathogen to antibiotics, and only then begin treatment. Nowadays, indiscriminate use of antibiotics leads to the fact that microorganisms develop resistance to drugs faster than pharmaceutical companies can produce them. Ultimately, we may end up with a situation where we simply run out of antibiotics.

Because of this, competent specialists prefer to wait for the test results and only then prescribe the necessary drug. If the drug is prescribed earlier and is not the one needed, then this will not make the body better, but the microorganism will begin to develop resistance to this drug. And although in this situation this is not so critical, because the bacteria will not be able to spread much, but even in such a situation we must not forget about it.

While treating bacterial prostatitis with antibiotics, you should completely eliminate alcohol from your diet. Even small doses of alcohol, such as a glass with dinner, can weaken the effect of antibiotics and also worsen your overall condition.

Another important nuance is the fact that all strong antibiotics have a sperm toxic effect. Therefore, after finishing taking antibiotics and before the date of conception, about 5-6 months should pass.

In addition, during treatment with antibiotics, you should try to take other measures that will help improve the functioning of the prostate gland. Massage procedures, various therapeutic treatments and, of course, taking vitamins are well suited.

Antibiotic groups

Please remember that what is written below is for informational purposes only. Under no circumstances should you independently diagnose prostatitis in yourself or someone you know and treat it without consulting a specialist.

There are 6 main groups of antibiotics that can help a person overcome prostatitis

Penicillins

Amoxicillin and Amoxiclav. Doctors like to use this group of antibiotics due to the fact that their effects have been well studied. Amoxiclav is available in powder, tablet or oral suspension form. A single dose is 250 or 500 mg, the daily dose should not exceed 2 g. It is recommended to divide the drug intake into 3-4 doses. Amoxicillin is mainly used in tablet form. A single dose is 500-1000 mg, the daily dose should not exceed 3 g. The drug intake is also divided into 3-4 times.

Tetracyclines

Doxycycline and Tetracycline. Antibiotics of this series are prescribed, as a rule, for prostatitis caused by chlamydia or mycoplasma. The release form of tetracycline is tablets. A single dose is 250 mg. The daily dose does not exceed 1 g. The drug should be taken 4 times a day. Doxycycline also comes in tablet form. A single dose is 100 mg. The daily dose does not exceed 200 mg. Must be taken 2 times a day.

Cephalosparins

Ceftriaxone and Cefuroxime - these antibiotics have a wide spectrum of action. Ceftriaxone and Cefuroxime are able to fight anaerobic infections, as well as both gram+ and gram-bacteria (Proteus, staphylococcus, streptococcus and Haemophilus influenzae). Ceftriaxone is administered exclusively parenterally, that is, intravenously or intramuscularly. There is no tablet form. The single and daily dose ranges from 1 to 2 g. This is due to the fact that the drug is administered only once a day. The route of administration of cefuroxime is the same as that of ceftriaxone. A single dose ranges from 750 to 1500 mg, and a daily dose from 2 to 6 g. Taken 3 times a day.

Fluoroquinolones

Oflaxacin and Ciprofloxacin have a wide spectrum of action. They are not the drugs of choice. Their main feature is that they penetrate well into the prostate tissue and accumulate there. They are used to detect many gram+ and gram- bacteria, as well as chlamydia, mycoplasma gardnerella and ureaplasma. Oflaxacin is produced exclusively in capsules. Capsules come in 200 and 400 mg. Taken once a day. Ciprofloxacin comes in tablet form, but is more often used as an injection. A single dose is 200 or 400 mg. The daily dose can reach 800 mg. Take the drug 2 times a day.

Macrolides

Josamycin and Azithromycin, which is also called Sumamed.

The main difference is the ability to accumulate in prostate tissue. The advantage of this series of antibiotics is low toxicity. Josamycin is available in tablet form. A single dose is 250, 500 or 750 mg. Daily dose 1-2 g. Taken 3 times a day. Azithromycin comes in tablet and powder forms for injection. A single dose is 150 or 300 mg. Daily – 300 or 600 mg. The drug is taken 1-2 times a day.

Aminoglycosides

Kanamycin, Gentamicin, 5-NOK. These antibiotics have a wide spectrum of action and are used in situations where it is impossible to accurately determine the causative agent of prostatitis. Gentamicin is available only in the form of an injection solution. It is used at the rate of 2-5 mg per 1 kg of human body weight, 1-3 times a day. Kanamycin has the same release form. Its single dose is 500 mg. The daily dose does not exceed 1-2 g. It is taken 2-4 times per day. 5-NOK is available in the form of tablets. A single dose is 100-200 mg. The daily dose reaches 800 mg. Taken 4 times a day.

We remind you once again that the specific treatment regimen must be determined by the doctor. Today there is no ideal treatment regimen for prostatitis that would suit absolutely all people.

In case of acute prostatitis, you need to take antibiotics for about 2-4 weeks. Then you will need to take the tests again and, if necessary, take another course of the drug.

What people who are prescribed a course of antibiotics should understand

1. Antibiotics cause the body's immunity to decrease due to the suppression of normal microflora. To maintain immunity, doctors recommend taking a course of probiotics immediately after or while taking antibiotics.
2. Antibiotics quite often cause allergic reactions. To prevent this from happening, it is recommended to take a course of antihistamines. These drugs, in addition to preventing allergic reactions, also prevent the development of candidiasis.
3. Long-term use of antibiotics has a negative effect on the liver. During long-term use of antibiotics (over 2 weeks), you should periodically take a course of hepatoprotectors.
4. If after completing the course of treatment you do not feel relief, you should inform your doctor about this. In the case of acute pancreatitis, improvement can be observed on days 5-6.
5. It is strictly forbidden to independently reduce the dosage or suspend the course of treatment. If you feel better and then reduce the dosage of the drug or stop taking it altogether, the symptoms will return because the microorganism causing the disease has not yet been completely destroyed.
6. If you take antibiotics in tablet form, you should combine them with meals. The fact is that antibiotics, like many other drugs, have a destructive effect on the gastric mucosa. Taking the tablets with meals or a small snack will protect you from developing ulcers.

In case of chronic prostatitis, it is necessary to regularly take courses of antibiotics.

This is due to the fact that it is impossible to completely cope with chronic prostatitis in one course of treatment.

In custody

Many men are ashamed of prostatitis and because of this they are afraid to consult a specialist. There is nothing shameful about this disease. Nowadays, many people have a weakened immune system, and the cause of bacterial prostatitis can be a banal visit to a sauna or swimming pool.

And remember again, all attempts to independently treat prostatitis will only lead to the fact that it will turn from an acute form into a chronic one and you will still need to see a specialist, but the consequences will be much worse.

Take care of your health and do not be afraid to contact specialists.

Prostatitis is an inflammation of the prostate gland, accompanied by pain in the groin, scrotum and perineum, urination problems and erectile dysfunction. The severity of the manifestations of the disease will depend on its form. The type of prostatitis also largely determines the treatment tactics and prognosis for this disease.

Classification

The American National Institute of Health (NIH USA) in 1995 developed certain criteria according to which the disease is divided into several types:

• Category I – acute prostatitis.
• Category II – chronic bacterial prostatitis.
• Category III - chronic non-bacterial prostatitis (chronic pelvic pain syndrome).
  • Chronic inflammatory pelvic pain syndrome.
  • Chronic non-inflammatory pelvic pain syndrome.
• Category IV – asymptomatic chronic prostatitis.

The classification does not mention a rare form - chronic granulomatous prostatitis.

Prostate inflammation is often combined with pathology of other genitourinary organs. With prostatitis, urethritis, cystitis, and vesiculitis are detected. In older men, inflammation of the prostate often occurs simultaneously with its benign hyperplasia.

Acute prostatitis

Acute inflammation of the prostate gland develops when infected with various microorganisms. The examination reveals E. coli, enterobacteria, staphylococci, Klebsiella, Proteus and other representatives of opportunistic flora. Penetrating into the prostate tissue, these bacteria can cause inflammation. The disease usually occurs against a background of decreased immunity.

Symptoms:

• fever;
• rise in rectal temperature (even with normal temperature in the axillary area);
• signs of general intoxication: severe weakness, muscle pain, headaches;
• severe pain in the perineum, scrotum, lumbar and groin area, rectum;
• dysuric phenomena: frequent urination, nocturia (frequent urge to empty the bladder at night), pain and burning during urination;
• difficulty urinating up to acute retention;
• constipation and pain during bowel movements.

On rectal examination, the prostate gland is sharply painful and enlarged. There is an increase in lymph nodes.

Treatment of acute prostatitis involves taking antibiotics. Analgesics, antispasmodics, diuretics, and anti-inflammatory drugs must be prescribed. In case of acute urinary retention, bladder catheterization or temporary fistula is performed. Thermal procedures and prostate massage are not indicated in the acute stage. If purulent complications develop, surgical treatment is performed.

Chronic bacterial prostatitis

The main cause of pathology is the proliferation of opportunistic bacteria. The risk of the disease increases with hypothermia, a sedentary lifestyle, as well as in the presence of other genitourinary pathologies.

Chronic prostatitis develops over many years and can be asymptomatic for a long time. There is an alternation of exacerbations and remissions. When the process worsens, the following symptoms occur:

• dull aching pain in the perineum, rectum, scrotum, lower abdomen and lumbar region;
• frequent urination in small portions;
• decreased potency.

The man's general condition is not affected; his body temperature remains normal. The severity of dysuric phenomena may vary. There is increased nervousness, irritability, and irascibility.

Antibiotics and anti-inflammatory drugs are used in the treatment of this form of pathology. The course of antibiotic therapy lasts at least 8 weeks. The use of immunomodulators is indicated. The use of physiotherapeutic methods has a good effect.

Chronic non-bacterial prostatitis

This form of the disease is considered the most common and accounts for 95% of cases of prostatitis. The occurrence of the disease is associated with impaired blood flow and a malfunction in the immune system. The role of microorganisms in the development of prostate inflammation cannot be ruled out. A certain role is allocated to urethro-prostatic reflux (reflux of urine from the urethra into the prostate).

The symptoms are similar to those of chronic bacterial prostatitis. This form of pathology can be determined by performing bacteriological culture. Microorganisms are not detected in prostate secretion and ejaculate, which allows for an accurate diagnosis and selection of treatment.

Treatment of chronic non-bacterial prostatitis involves the use of drugs that improve blood flow in the organ. The use of anti-inflammatory drugs and immunomodulators is indicated. Prostate massage and physiotherapy are used. The issue of prescribing antibiotics is decided individually.

Chronic asymptomatic prostatitis

The disease is asymptomatic. The only symptoms are periodic bacteriuria and leukocyturia - the detection of bacteria and leukocytes in the urine. When searching for the cause of this condition, after a full examination, chronic prostatitis is often revealed. There is no treatment. Observation by a urologist is indicated.