Correctly choosing antibiotics is fundamental to the success of therapy. As an enormous range is available on the market I shall just indicate the drugs we use and give the reasons for our choice.
When bacteria have been isolated in cultures we use the most specific antibiotic indicated on the antibiogram. If the isolated bacteria is Gram- we combine the specific antibiotic. with Gentamycin or Tobramycin to provide wide spectrum cover against Gram+ germs that might be present, e.g. Streptococcus. If the isolated bacteria is Gram+ we add Aztreonam or Ciprofloxacin to cover Gram- bacteria.
When Chlamydia or Mycoplasma are detected in fresh or cultured samples or by DNA amplification or if their presence is hypothesized because of positive specific IGG and IGM we administer Claritromycin together with Levofloxacin. When protozoi are identified, they are usually trichomonas, and we give Metronodazol.If no bacteria can be isolated (as in most cases) we administer Gentamicyn to eradicate Gram+ germs in association with Cipro to combat Gram- germs.
Keep in mind that administration of 1gr antibiotic directly into the prostatic capsule is the equivalent of a systemic dose 2.000-2500 times higher (that is, it is two to two and half thousand time more powerfull).
Infiltration treatment possible side effects
Symptoms worsening for 12-48 hours (very often)
Haemospermia on the following 2-3 ejaculations (about 70% of cases)
Urinary flow difficulty on the following 6 hours (rare)
Reduction or loss of erection on the following 7-15 days (very rare, about 5% of cases)