Post Date April, 15 2023
Many patients with chronic prostatitis have been treated with various drugs for a long time, but their symptoms have not improved significantly, resulting in many questions and confusion, and even doubt that their disease can not be cured. This article briefly introduces the common drug treatment methods of chronic prostatitis, so that patients can understand the drug treatment of chronic prostatitis.
1、 Anti-infective drug treatment
For bacterial prostatitis, antibiotic treatment is obviously necessary and effective. Because when suffering from chronic bacterial prostatitis, it is difficult for many kinds of antibiotics to spread to the infected lesions in the prostate tissue to achieve bactericidal effect, most doctors choose long-term and sufficient effective antibiotics for treatment. For patients with symptoms during the attack, the drug can be used for up to 12 weeks, and for patients without symptoms during the attack, it can be used for about 6 weeks. For patients with recurrent attacks, it is also necessary to use antibiotics prophylactically.
For patients with chronic non-bacterial prostatitis, it is also necessary to give 2 to 4 weeks of antibiotic treatment because they may be infected with some pathogens that are difficult to cultivate or identify. If the symptoms improve, it can be used for another 2-4 weeks; If the effect is not obvious, the treatment plan needs to be readjusted. The course of treatment of chronic non-bacterial prostatitis with antibiotics is generally less than 8 weeks. Long-term application of antibiotics can not only kill the remaining pathogens of drug resistance, but also may lead to flora imbalance and even secondary infection.
The preferred anti-infective drugs are third-generation quinolones, such as levofloxacin, norfloxacin, enoxacin, etc. These drugs are fat-soluble and can reach high drug concentration in the prostate. At the same time, they have a broad antibacterial spectrum and have good killing effect on Escherichia coli, Proteus, Staphylococcus, etc. Sulfonamide drugs, such as compound sulfamethoxazole (SMZ-CO), are a kind of traditional drugs for the treatment of chronic bacterial prostatitis. This kind of drug has a high concentration in the prostate, has a good bacteriostatic or bactericidal effect, and is relatively cheap, which is easy to be accepted by the majority of patients. However, due to its toxicity and side effects, quinolones are more used in clinic. In addition, macrolides are often used clinically, such as erythromycin, azithromycin, minocycline and clarithromycin, to treat some patients with chronic non-bacterial prostatitis who may be infected with chlamydia and mycoplasma.
It should be emphasized that patients with chronic prostatitis may not achieve obvious results by using anti-infection therapy alone. Antibiotics often need to be combined with other drugs to play a therapeutic role. However, it is very necessary and important for patients with chronic prostatitis to be treated strictly according to the antibiotic regimen recommended by doctors. Irregular use of antibiotic treatment will eventually lead to drug resistance of pathogens, making future treatment more difficult.
2、 Drug treatment to relieve contraction and spasm of pelvic floor muscles
Patients with chronic prostatitis often feel bloating, soreness and even severe pain in the perineum or prostate region. These symptoms are mainly caused by habitual contraction and spasm of pelvic muscles. The use of drugs to relieve pelvic muscle contraction and spasm can significantly alleviate the above symptoms, which is beneficial to the treatment of chronic prostatitis.
α- Adrenergic receptor（ α 1 - AR) blocker can relieve the spasm of bladder neck and prostate urethra, prevent urine reflux in prostate, improve urination symptoms, relieve pelvic floor muscle spasm and relieve pelvic floor muscle pain. The drugs in this category include piperazine, terazosin (Gottlin), doxazosin, and tamsulosin hydrochloride (Hale). The advantages of prazosin are definite curative effect, low price and certain improvement of sexual function. However, there are obvious differences in the tolerance and treatment effect of this drug among different patients. The individual dosage of the patient needs to be constantly adjusted so that the patient can relieve symptoms without side effects such as postural hypotension. Both terazosin and doxazosin belong to α 1 - adrenergic receptor（ α 1 - AR) blocker, a kind of selective α- Adrenergic receptor blockers are generally taken before bedtime, once a day, which is relatively convenient, with mild adverse reactions and definite curative effects. Patients can choose these drugs first. Tamsulosin hydrochloride is α 1A - adrenergic receptor（ α 1A - AR) blocker, because it specifically blocks the α 1A - AR, while for α 1B - AR has no blocking effect, so its side effects are less. It is a relatively mild and efficient drug. However, the price is relatively high, which is suitable for patients with better economic conditions.
β- Adrenergic receptor（ β- AR) Blockers, such as diazepam (diazepam) for α- Adrenergic receptor（ α- AR) blockers also have a certain effect on patients without response. At the same time, it can relieve the tension and anxiety of patients, and can also be used as an auxiliary drug for psychological treatment of patients with chronic prostatitis. Use as usual α- AR blocker can have better curative effect.
(Intern editor: Huang Junda)
