Infections of the prostate occur when bacteria, such as Escherichia coli, Klebsiella sp., or Enterococci sp., reach the prostate from the urinary tract or the bloodstream. It is characterized by fever, chills, lower back pain and frequent and painful urination and is commonly treated with antibiotics. The National Kidney and Urologic Disease Clearinghouse recommends intravenous administration of the antibiotics followed by oral therapy for 2 to 4 weeks to treat acute infections. Chronic infections may be treated with low dose of antimicrobials for 6 months to prevent recurrent infection.
Trimethoprim/Sulfamethoxazole (TMP/SMX)
TMP/SMX is the most common antibiotic used to treat prostate infections. It is a combination of two drugs--trimethoprim and sulfamethoxazole--that work together by inhibiting the reproduction of the bacterial cells. This antibiotic penetrates well into the prostate tissue and can be given orally or intravenously, depending on the condition of the patient.
The duration of therapy for TMP/SMX as well as for other antibiotics used to treat prostate infections is not well studied. In an article published in the May 2000 edition of American Family Physician, Dr. James J. Stevermer states that about 40 percent of urologists and 65 percent of primary care physicians prescribed antibiotics for only two weeks . However, many experts believe that taking antibiotics for less time may lead to chronic infections which can be difficult to treat and hence, recommend antibiotics for at least 3 to 4 weeks.
Common side effects of TMP/SMX include loss of appetite, diarrhea, nausea and vomiting. Severe allergic reactions such as difficulty in breathing, tightness in the chest and swelling of the mouth, face, lips, or tongue may occur. It is important to contact the doctor immediately in such cases.
Tetracyclines
Tetracyclines, such as doxycycline and minocycline, work by preventing the growth and spread of bacteria. They are especially effective against prostate infections caused by mycoplasma or chlamydia, which are common in men with sexually transmitted diseases. The University of Maryland Medical Center warns of side effects such as skin reactions to sunlight, possible burning in the throat and tooth discoloration.
Quinolones
Quinolones, like ciprofloxacin and norfloxacin, act by preventing the duplication of the bacterial genetic material and are used to treat acute and chronic prostate infections especially when TMP/SMX therapy fails. Dr Kurt Naber states in the July-August 1989 edition of Review of Infectious Diseases that quinolones can reach high concentrations in prostatic and seminal fluid and prostate tissue. And, unlike certain other antibiotics, such as erythromycin and clindamycin, which reach high concentrations in prostate but are ineffective against the common bacteria responsible for prostate infections, quinolones can act against a wide range of bacteria and are also useful against Chlamydia trachomatis and Ureaplasma urealyticum.
Side effects are usually mild and include nausea, vomiting, abdominal pain and dizziness.
Cephalosporins
In the May 2000 edition of "American Family Physician," Dr. James J. Stevermer recommends intravenous administration of cephalosporins along with aminoglycosides to all the extremely ill patients, such as those with sepsis. Cephalosporins disrupt the bacterial cell wall, thereby causing cell death. Common side effects include diarrhea, nausea, rash, electrolyte disturbances, and inflammation at injection site.
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