Post Date December, 03 2023
In clinical practice, 80% of prostatitis is accompanied by seminal vesiculitis and hematospermia occurs. It is difficult to distinguish between prostatitis and seminal vesiculitis. Almost all prostatitis and seminal vesiculitis have posterior urethritis, while about 40% of posterior urethritis is accompanied by prostatitis. Therefore, there is no need to consider the selection of anti inflammatory and antibacterial drugs for acute prostatitis or acute seminal vesiculitis separately.
In addition to general treatment, antibacterial treatment is very important for the treatment of acute prostatitis or acute seminal vesiculitis with hematospermia, and there is no need for hemostatic treatment. However, due to the presence of a lipid membrane on the surface of the prostaglandins, it is difficult for many antibiotics to penetrate through this membrane and achieve therapeutic effects in the glands. The following principles should be followed:
(1) Selection should be based on drug sensitivity.
(2) Choose antibacterial drugs with high lipid solubility, high permeability, low binding rate with plasma proteins, and high dissociation.
(3) Use a combination medication with sufficient dosage and a long course of treatment. The medication should take more than 4 weeks.
Common drugs and medication methods:
(1) Erythromycin: Erythromycin has strong penetration and strong penetration effect on prostate epithelium. It can be dissociated into an insoluble state in an acidic environment, and is highly sensitive to Staphylococcus aureus and Streptococcus, but not effective against Gram negative bacteria. Therefore, it is often used in combination with kanamycin. Usage: Erythromycin 0. 25g, 4 times a day; Kanamycin 0. "5g, twice daily, intramuscular injection, for a total of 10-14 days as the first course of treatment. After symptoms improve, it is changed to oral administration of Compound Xinnuo Ming, 2 tablets per time, twice daily, for 10-14 days.".
(2) Compound Xinnuo Ming: The medication for compound Xinnuo Ming is 2 tablets, twice a day, for 4-6 weeks. When taking this drug orally, alkaline drugs can be taken simultaneously to improve the efficacy.
(3) Cephalosporins and TMP: They can enter the prostate through blood to achieve anti-inflammatory and bactericidal effects. Commonly used are cefradine VI capsules, taken orally 2 capsules (500 mg) each time, 4 times a day. In severe cases, 4-8g per day can be administered intravenously twice, but it should be noted that it is prohibited for those with a history of allergy to cephalosporins, and it should be used with caution for those with allergies to penicillin. The usage of TMP is mostly compound preparations, which are used together with sulfanilamide. Compound TMP refers to compound sulfamethoxazole.
(4) Quinolones: In recent years, antibacterial drugs have developed rapidly, and anti-inflammatory drugs for acute prostatitis have also increased significantly. The use of quinolones includes norfloxacin 0. 2g, taken orally three times a day; Ofloxacin 0, 2 g, oral, twice daily; When the condition is serious, intravenous infusion of Ofloxacin, 0 or 2 g each time, twice a day, for a course of 10 to 15 days. The adverse reactions were gastrointestinal symptoms, with occasional elevated alanine aminotransferase. Change to other antibiotics for improvement.
(5) Penicillin drugs: Some penicillin drugs are effective against specific bacteria in the urinary tract. The effect caused by non specific bacterial infections is not ideal and is generally not considered as the first choice.
