Prostatitis Forum & Social Network

Acute and chronic prostatitis discussion. Arnon Krongrad, MD, moderator.

Dr. Krongrad,
The site has grown quite a bit since I last used it. I think I was the 9th person to join in 2008? That's GREAT! Anyway, I am 23 years old and have had chronic prostatitis since July 2008. I have been able to keep a rangle on my prostatitis with the use of antibiotics. I do have flare ups but I increase the dosage and it knock it out. (I am currently on a maintaining regimen when it comes to antibiotics: I usually only take half to 1/4 of the full dosage a day, and it works!) Anyway, I have been on different antibiotics since I was diagnosed in July of 2008. I was wondering if there is any REALLY big problems with being on antibiotics for so long? Is this going to weaken my immune system so much that I am seriously suceptible to more dangerous infections or life threatening diseases? I am currently on Keflex? I am young and I plan on getting your surgery done one day...after kids and such, but that could be 10 years or so, so I am probably going to have to depend on the medicine until then I assume. That's why I ask! Thank you so much for your time Dr. Krongrad.
Thanks,
Smith Marks

Tags: antibiotics, chronic, ciprofloxacin, dr, effects, immune, keflex, krongrad, prostatitis, risk, More…side, symptoms, system

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Replies to This Discussion

Antibiotics are associated with a number of side effects and can explain some of the comorbidities seen in chronic prostatitis. Irritable bowels is probably the most common of antibiotic-explained comorbidity. Among the most serious complications of antibiotic use is the loss of kidney function (nephrotoxicity) and inability to balance (ototoxicity), as described by this patient.

There is a mouse experimental model showing antibiotic treatment of urinary tract infection can be associated with greater susceptibility to future infection. The specific relevance to prostatitis in humans is unclear, but the findings do raise a very interesting question about the possibility that treating prostatitis with antibiotics may in some cases actually cause a life-long perpetuation of symptoms.
Also for your interest: Ciprofloxacin and intestinal bacteria.

Incidentally, last week I received a call from a patient who had been treated for a month of Cipro after initial diagnosis. He now also has severe hip pain and an MRI has shown internal muscular tendonitis. He's in a tough spot, dealing with bad prostatitis and inability to walk. He has been treated with methotrexate for presumptive reactive arthritis, but this has not helped him.

Ortho-McNeil Janssen, makers of levofloxacin (Levaquin), has issued an important drug warning relating to the association of Levaquin  with tendonitis and tendon rupture.

 

You can read the warning here.

As a followup ...

 

A recent prostatectomy patient informed me that a few weeks ago, after having been on Cipro for 6 weeks, he acutely developed bilateral foot swelling and intense pain. This patient had a severe case of chronic prostatitis, for which over 11 years he took great quantities of antibiotics.

 

The diagnosis was bilateral compartment syndrome, most commonly seen after major trauma, which he had not had. Emergency bilateral fasciotomy surgery, evidenced by his scars, saved his legs from certain amputation.

 

The orthopedic surgeon determined that this was compartment syndrome from chronic use of quinolone antibiotics. He had seen a handful of other such cases.

 

Is prostatitis a benign illness?

Are antibioitics a benign treatment?

Antibiotics are like a double-edged sword.  they're better than doing nothing, but I'm not thrilled with their long-term efficacy and side-effects.  About 1/2 of the way through my treatment regimen of my second bout of recurrent bacterial prostatitis, I developed a bad reaction to Cipro.  I'm  highly sensitive to drugs to begin with, but Cipro is a very strong agent, with a relatively long half life, making it annoying to eliminate if you've had a bad reaction to it.   My brain seemed to be on fire...it was as if I had taken a million speed pills or something and I had some involuntary movements in my arms and legs when resting.  These movements and the "hyperactive" feeling made it impossible to sleep.  I was crazed for about 2 days until it wore off.  I'm on something called Augmentin now, which is a derivative of penicillin, which seems more "quaint".  :)   the downside is that it penetrates the prostate less effectively, I think. 

A link for checking medication side effects:  http://treato.com/ 

As a former big supporter of long term antibiotics use, let me give my 2 cents on the long term effects of oral antibiotics. oral antibiotics generally just don't work for chronic prostatitis and the reasons could be for a couple of reasons.


1. If there is an infection hiding in their the chances of oral antibiotics killing this hidden infection will be very slim. Let me give you an example in my readings I have found that generally the concentration in the urinary system of oral trimethoprim, ciprofloxacin , and keflex(cephalexin) reaches concentrations of 150 -200 ug/ml in the urinary system. So lets say an individual has a strong ecoli infection in his urine and it is a pretty stout infection and it is going to take 50 ug/ml of that trimethoprim or cipro or keflex to kill it. This will be easily done by the antibiotics and the patient will be happily cured quickly with his prescribed oral medication. Now if we took that same ecoli bacteria and put it in a mans prostate and it takes 50 ug/ml of an antibiotic to kill it, meaning if the antibiotic can not hit 50 ug/ml concentration in that prostate the infection will not die. So if the man takes the correct antibiotic and the antibiotic has to reach 50 ug/ml to kill this ecoli and the max that the oral antibiotic of choice can reach is 10 ug/ml in the prostate he will never kill this infection even if he takes that oral antibiotic for 6 months it can not die unless the 50 ug/ml is reached in that prostate. This is a possible scenario for some men with prostatitis. And to be honest I have read plenty of studies for example men who had ecoli in the prostatic fluid and trimethoprim was the drug of choice and after 90 days the fluid was tested again and some men were completely cured while others still had ecoli in the prostatic fluid then the study stated so many percent of patients could not be cured with 90 days therapy.  

2. There may not be an infection to begin with.

But suffice to say,I've done way to much long term antibiotic use and ended up with green diarrhea a couple of times. My last time taking trimethoprim was a real mess not only did it make symptoms worse, it messed with my head pretty bad. Injections could be a better option because it gets the medicine where it needs to go which is in the prostate, instead of all through the  body messing up good bacteria in the colon causing stomach aches and green diarrhea, cephlasporins such as keflex are notorious for causing C diff. also many antibiotics cross the blood brain barrier and the last thing you want is a bunch of antibiotics getting inside of your brain. Which goes back to my own case I took a heavy and I mean a heavy amount of antibiotics altogether recently 1500 mg cipro for 28 days , followed by cefadroxil for 2 weeks, followed by trimethoprim, and I was in a lot of pain and it messed my head up bad, had awful nightmares, panic attacks, and some crying episodes. And I still don't feel quite right in the head, it feels like I am stoned or high, this feeling has been going on for 4 days. My advice is be very cautious on oral antibiotic use.

I will close with the following, IMO scientists need to come up with something better than the antibiotics for killing infections. Not only are they dangerous and full of side effects, if you have something that is very resistant you may have to take them long terms. I recently read about a woman with chronic lyme disease stating that she was taking 4 grams ceftriaxone for 15 and a half months. Just imagine the damage that could occur with that much antibiotic running through the system system daily for over a year. 

Guys, have somebody tried prulifloxacin?  http://www.ncbi.nlm.nih.gov/pubmed/23934982
Take a look at this article and others. This particular drug seems to be quite efficient against E.coli.

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