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 List of Medications for Bacterial Prostatitis 
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Joined: Tue Feb 23, 2016 6:49 pm
Posts: 133
Post List of Medications for Bacterial Prostatitis
This should act as an guide and list only for people that know or have found bacteria in their prostate. This should not be viewed as an alternative cure method for people who have the non-bacterial prostatitis disease. This list is simply based of medicines for bacterial prostatitis.

Background:
There are tons and tons of websites and sources and medical researches on the web involving prostatitis tests and other stuff. It may be hard to find it all or find something particular you are looking for or even a curing method to your disease which hopefully this guide/list will be helpful for. This is not a cure but just a simplified text based on research and web from the internet and sources.

I will list medicines by family and generic name in alphabetical order.

BP = Bacterial Prostatitis
Broad-spectrum = Works with both gram-negative and gram-positive bacteria
E Faecalis = Enterococcus faecalis, gram-positive
E Coli = Escherichia coli, gram-negative
Chlamydia = Chlamydia trachomatis, gram-negative
Gonorrhea = Neisseria gonorrhoeae, gram-negative
Mycoplasma = gram-negative, should be gram-positive but evolved gram-positive bacteria but lost their cell wall and therefore became gram-negative

Fluoroquinolones family
This medicine have a blackbox warning means it can significally harm you by taking it's doses, are should not be recommended as a first alternative treatment, not even a second alternative. This should only be reviewed as a last resort treatment as this can significally harm and cripple your body by other means. The warning was increased even back in 2016, Autumn.

- Ciprofloxacin
Broad-spectrum antibiotic
Generic names: Cipro.
Have a high efficiently rate towards BP caused by E. Coli and E. Faecalis. Although many strains of E Faecalis and E Coli have shown to be resistant to Ciprofloxacin.
Prostate penetration strength: High

- Levofloxacin
Broad-spectrum antibiotic
Genereric names: Levaquin.
Have a pretty high efficiently rate towards BP caused by E Coli and E Faecalis. Also here many strains have shown resistance to E Faecalis and E Coli to Levofloxacin.
Prostate penetration strength: High

- Moxifloxacin
Broad-spectrum antibiotic
Generic names: Avelox
Have the highest efficiently rate of all fluoroquinolones towards BP caused by E Coli and E Faecalis. Some strains have found resistance but most are very susceptible to moxifloxacin.
Prostate penetration strength: High

Tetracyclines family
Tetracyclines is a pretty harmless antibiotic for your body, with no long term effects. Most common side effect is a upset stomach. Cross resistance is common among them, because of a similar antimicrobial spectra.

- Doxycycline
Broad-spectrum antibiotic
Generic names: See your country
Have a high efficiently rate towards chlamydia, also works against mycoplasma, e. coli, gonorrhea. Not common with resistances, but some have occured. Ineffective against E Faecalis
Prostate penetration strength: Medium/high

- Tetracycline
Broad-spectrum antibiotic
Generic names: See your country
Effective against chlamydia and e. coli, gonorrhea. Ineffective against mycoplasma and E faecalis
Prostate penetration strength: Medium/high

- Minocycline
Broad-spectrum antibiotic
Generic names: See your country
Effective against chlamydia, gonorrhea, mycoplasma, e coli. But because cross-resistance is common among tetracyclines, culture and susceptibility tests are recommended.
Prostate penetration strength: Medium/high

- Lymecycline
Broad-spectrum antibiotic
Generic names: See your country
*Unknown info, someone who can fill in?
Prostate penetration: Medium/high

Glycylcycline family
Common side effects are nausea, diarrhea, vomitting.

- Tigecycline
This drug contains the black box warning. Risk of death included.
Source: http://prostatitis.org/redirect.php?lin ... by-pfizer/
Broad-spectrum antibiotic
Generic names: Tygacil
Is a antibiotic you administrate intravenously. Effective against E faecalis, E coli, mycobacteria. Is susceptible against vancomycin resistant strains. (E faecalis)
Prostate penetration strength: Unknown, lack of clinical evidence. Characteristics show that it may not have good penetration, however it derived from minocycline which is regarded having good prostatic penetration

SMZ-TMP sulfamethoxazole-trimethoprim
Is a two-in-one antibiotic, where as sulfamethoxazole act as antibiotic agent and trimethoprim as inhibitor, which results in double strength.
Broad-spectrum antibiotic
Generic names: Bactrim
Effective against E coli, not effective against E faecalis. Very poor choice for E faecalis treatment.
Prostate penetration strength: Medium/high

Penicillin family
Penicillin is pretty harmless for your body, with no long term effects. Most common side effects are upset stomach. Allergies have been seen.

- Amoxicillin
Broad-spectrum antibiotic
Contains of amoxicillin and clavulanate potassium, to increase the effectiveness and reduce the chance of the bacteria becoming resistant.* (can someone confirm this?)
Generic names: Augmentin
Effective against E faecalis, e coli, gonorrhea. not effective against chlamydia.
Prostate penetration strength: Unknown/low?* (if you can find any source of this please share how the prostate penetration is)

- Ampicillin
Broad-spectrum antibiotic
Generic names: See your country
Effective against e faecalis, e coli, gonorrhea, same as Amoxicillin basicly.
Prostate penetration strength: Unknown/low?* (check amoxicillin)

Glypopeptide family
- Vancomycin
Broad-spectrum antibiotic
As far as I can understand, it's both available intravenously and in pill form?* (confirm?)
Generic names: Vancocin, others
Effective against E faecalis, for example amoxicillin-strain resistant e faecalis bacteria.
Prostate penetration strength: Unknown, *can someone find any clinical research about this?

Nitrofurantoin
Broad-spectrum antibiotic
Generic names: Macrobid, Furadantin, and others
Very effective against E faecalis perhaps the most effective in the world, however can only be used for UTI. Effective against e coli.
Prostate penetration strength: None
*(I Wonder if there is any other pill you can take simultaneously with this that allows the body for Nitrofurantoin to enter the prostate?)

Carbapenem family
- Ertapenem
Exceptional broad-spectrum antibiotic
Generic names: See your country
Is a antibiotic you administrate intravenously. Not very effective against E faecalis.
Prostate penetration strength: Unknown

Ureidopenicillin family
- Piperacillin-tazobactam
Broad-spectrum antibiotic
Generic names: See your country
Is a antibiotic you administrate intravenously. Effective against E. Faecalis and gonorrhea.
Prostate penetration strength: Unknown

Oxazolidinone famiyl
- Linezolid
Broad-spectrum antibiotic
Generice names: Zyvox
Effective against E. Faecalis, not very effective against E coli. No effect against Chlamydia.
Prostate penetration strength: Medium/high* (can someone confirm this? I just read one source that it has same penetration as doxycycline)

Lipopeptide family
- Daptomycin
Broad-spectrum antibiotic
Generic names: Cubicin
Is a antibiotic you administrate intravenously. Effective against E faecalis.
Prostate penetration strength: Unknown

Cephalosporins family
- Cephalexin also called Cefalexin
Broad spectrum antibiotic
Generic names: Keflex, Cepol, Ceporex, others
Effective against E Coli, not very effective against E faecalis
Prostate penetration strength: Unknown

- Ceftriaxone
Broad spectrum antibiotic
Generic names: Rocephin
Is a antibiotic you administrate intravenously. Effective against E coli and gonorrhea. not effective against e faecalis
Prostate penetration strength: Medium/high

Fluconazole
Antifungal medication
Generic names: Diflucan, celozole, others
Is a medicine for treating anti fungal, such as candida. Not for antibacterial.
Prostate penetration strength: See research
http://prostatitis.org/redirect.php?lin ... 3.full.pdf

Macrolide family
- Azithromycin
Broad spectrum antibiotic
Generic names: Zithromax, and others
Effective against ureaplasma, mycoplasma, streptococci group C, F, G, mycobacterium, chlamydia, streptococcus.
Prostate penetration strength: High

Anti-infectives family
- Metronidazole
Common side effects are upset stomach, diarrhea, nausea, vomitting, stomach cramps.
Limited spectrum antibiotic (*Unknown? If broad spectrum or narrow spectrum, couldn't find an answer to this)
Generic names: Flagyl, Metro and others
Effective against trichomonas vaginalis.
Prostate penetration strength: Unknown *(Can someone find a clinical research about this?)

Fosfomycin
Broad-spectrum antibiotic
Generic names: Monurol, Monuril, or see your country
Effective against E faecalis, E coli, E faecium.
Prostate penetration strength: Unknown *(Someone have any clinical research or knowledge about how this drug penetrate the prostate?)


This is all I could find folks for now, that are susceptible for eliminating these bacteria you can get in the prostate. If you know of any other drug, feel free to make a input so I can add it.
For all the unknown fields, feel free to also help fill in missing information if you know or have any knowledge at all about it.

Also feel free to say if you have tested any of these drugs and what results you have got, but remember to also know that if you have being tested positive for a certain bacteria, and that it would work with the correct drug. For example Bactrim will not cure you if you have prostatitis caused by E faecalis, or if you have no success with Cipro because of most strains are resistant to it. Also most of these drugs should be taken for a longer period of time, up to between 3 to 26 weeks, for even seeing any result in change.


Last edited by Twister on Mon Jan 23, 2017 11:36 pm, edited 1 time in total.



Mon Jan 23, 2017 6:44 pm
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Joined: Tue Aug 04, 2015 6:50 pm
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Post Re: List of Medications for Bacterial Prostatitis
Awesome list! I would say that Ceftriaxone penetrates well, from mid to high. It's saved me from acute bacterial prostatitis a few times by itself (via IV, or daily IM injection) and was the only thing that worked when all other medications failed.

Zyvox is also interesting, I've probably read that same study, I unfortunately couldn't find anything else on it either. :/
It kills staph and enterococcus species that are vanco resistant.

Some guys on here say Fosfomycin penetrates well, but I haven't personally tried it yet. Supposed to work well for Enterococcus species.

We could possibly add the anti-fungal med Itraconazole. Not sure how well it penetrates the prostate, but it should work for candida UTI and is easier on the kidneys than fluconazole.


Last edited by Inflamed on Mon Jan 23, 2017 10:26 pm, edited 1 time in total.



Mon Jan 23, 2017 8:45 pm
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Joined: Thu Dec 22, 2016 1:03 pm
Posts: 35
Post Re: List of Medications for Bacterial Prostatitis
Thank you so much for this. Scrolling through google pages can take so long this is so useful


Mon Jan 23, 2017 8:45 pm
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Post Administrator
Here's the Full Monty on tissue penetration of prostate for Fosfomycin & CBP.

http://prostatitis.org/redirect.php?lin ... MC4776017/

It appears concentration in prostate tissue has been measured at 4 ug/g (micrograms per gram of tissue), but not clear what doses were used to get this concentration.

Their comment: "Since fosfomycin prostate levels are around 4 μg/g of tissue, and some isolates may have had MICs of >4 μg/ml, this may be the reason for some failures. We concur with other authors (12, 17, 18) who suggest that fosfomycin should not be used for treating CBP caused by microorganisms with MICs of ≥4 μg/ml."

MIC is the "minimum inhibitory concentration" for effective treatment, & apparently some pathogens require a higher concentration than was achieved with the dosing used. Interestingly, it seems Fosfomycin is more effective in acidic tissue environments, & prostate tissue is on the alkaline side.

"Another factor to consider is that fosfomycin activity is higher in an acidic environment, but the pH is alkaline in CBP (around 8.5), which might lead to decreased activity of the drug"

Would increasing the acidity of the prostate (by co-treatment with cranberry or some other acidifying agent) help with the effectiveness?

They still got a success rate of around 50%: "After a median follow-up of 20 months, 7 patients (47%) had a clinical response, and 8 patients (53%) had persistent microbiological eradication; 4/5 patients with MDRE isolates achieved eradication. There were no side effects."

It seems calcifications may have confounded the study...

"Lastly, prostatic calcifications were present in 4/7 (57%) patients with microbiological failure".

I'm not too good at math... What would the overall success rates be if they excluded the patients with calcifications?

_________________
Once you eliminate the impossible, whatever remains, no matter how improbable, must be the truth
Sherlock Holmes


Last edited by Administrator on Mon Jan 23, 2017 9:56 pm, edited 1 time in total.

prostate2010



Mon Jan 23, 2017 9:45 pm
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Joined: Tue Feb 23, 2016 6:49 pm
Posts: 133
Post Re: List of Medications for Bacterial Prostatitis
I wonder if you are resistant to the doxycycline family and the other cyclines in that group too, what antibiotic drug you should take if you have got chlamydia.

I also wonder what would be a better choice to try, if you are allergic or can't take a fluoroquinolone, what would be the better choice for treating E faecalis;
- Augmentin / Amoxicillin
- Vancomycin
- Linezolid
- Fosfomycin

since I can't find any related prostate penetration studies on any of these 4 drugs.. which is very weird.


Wed Jan 25, 2017 12:17 am
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Joined: Sun Oct 16, 2016 9:59 pm
Posts: 117
Post Re: List of Medications for Bacterial Prostatitis
Here's a rather wonky paper on: Penetration of Antimicrobial Agents Into the Prostate

http://prostatitis.org/redirect.php?lin ... ration.pdf

I expect tissue concentrations would need to be matched to the MIC (minimum inhibitory concentrations) for one's particular pathogen; & sensitivity (from culture) would also be imperative.

_________________
Once you eliminate the impossible, whatever remains, no matter how improbable, must be the truth
Sherlock Holmes


Wed Jan 25, 2017 1:03 am
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Joined: Tue Feb 23, 2016 6:49 pm
Posts: 133
Post Re: List of Medications for Bacterial Prostatitis
Metanoia wrote:
Here's a rather wonky paper on: Penetration of Antimicrobial Agents Into the Prostate

http://prostatitis.org/redirect.php?lin ... ration.pdf

I expect tissue concentrations would need to be matched to the MIC (minimum inhibitory concentrations) for one's particular pathogen; & sensitivity (from culture) would also be imperative.


On your link, it says that amoxicillin / augmentin is listed as source for good prostate penetrate tissue.

Then why isn't amoxicillin being used for treatment of prostatitis caused by E. faecalis and E. coli by doctors? It's weird..


Wed Jun 21, 2017 3:14 pm
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Joined: Tue Jun 20, 2017 5:57 pm
Posts: 33
Post Re: List of Medications for Bacterial Prostatitis
I've had what i believe is chronic bacterial prostatitis on and off for many years. enterococcus faecalis was found often and was either unsuccessfully treated by multiple rounds of antibiotics including augmentin, or i kept getting reinfected by my girlfriend at the time.

i went through a period of no symptoms for 4 years. it was only after taking 30 days of levaquin and finally taking low dose elavil that i was cured of my pelvic floor symptoms, however the levaquin likely gave me a whole other set of unpleasant symptoms for a long long time - all kinds of pains, what a neurologist diagnosed as benign fasciculation syndrome (my calves were twitching nonstop for about a year or more), etc.

I've had enterococcus faecalis again for the last 3 years and am ready to treat it aggressively again. now that i reviewed my notes and see that levaquin helped, and i see that this time it's sensitive to cipro, I'm going to request another culture to determine susceptibility to levaquin (if its sensitivity to cipro doesn't indicate it would be sensitive to levaquin) and also fosfomycin. if the latter works, ill definitely take that instead... though i am also considering skipping the antibiotics and seeing if elavil alone will work, wondering if enterococcus is actually not a problem in the prostate, since I'm hearing conflicting opinions. anyway, my point was to avoid levaquin at all costs if you can. it can make you feel like you're burning in hell for months if not years. or perhaps even permanently. read about people who've gotten "floxed" taking this group of dangerous drugs.


Wed Jun 21, 2017 6:28 pm
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Post Re: List of Medications for Bacterial Prostatitis
ps i should add that i suspected all antibiotics can cause serious problems since they alter the gut flora and that may cause autoimmune illness.
I'm guessing it would be good to go on a strict autoimmune protocol paleo diet (avoiding foods that could cause inflammation) and take lots of probiotics / eat fermented foods a couple hours after any antibiotics, to try to minimize the damage they do to you. I'm also thinking a course of antifungals would probably be a good idea too after completing ABs.


Wed Jun 21, 2017 6:32 pm
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Joined: Tue Feb 23, 2016 6:49 pm
Posts: 133
Post Re: List of Medications for Bacterial Prostatitis
Figured I might bump this thread to the top again, it's quite useful.

I'm curious if really e. faecalis is that bad bacteria? my old doc said many males have this bacteria in there without having any pain or condition and that it was harmless.


Tue Sep 26, 2017 1:00 pm
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Joined: Tue Aug 04, 2015 6:50 pm
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Post Re: List of Medications for Bacterial Prostatitis
Twister, love the list man, it is awesome!

I think enterococcus faecalis can become a problem for some guys if their systemic flora / immune system is off. The routine level of the enterroccocus population that resides in the prostate theoretically wouldn't be kept in check as a result and could then increase and cause problems. That's just a wild guess though.

I found this article at the NIH showing there's significant gut alterations between prostatitis sufferers and normal people.

http://prostatitis.org/redirect.php?lin ... MC5300850/


Tue Sep 26, 2017 2:46 pm
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Joined: Tue Apr 12, 2016 11:55 am
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Post Re: List of Medications for Bacterial Prostatitis
Isn't there at least one web site with a non-exhaustive list of antibiotics and anti-fungals? Not rx-list or something general like that...but more specific to treating certain conditions.


Thu Oct 12, 2017 4:40 pm
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Joined: Sun Jan 20, 2019 3:25 pm
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Post Re: List of Medications for Bacterial Prostatitis
Twister wrote:
Figured I might bump this thread to the top again, it's quite useful.

I'm curious if really e. faecalis is that bad bacteria? my old doc said many males have this bacteria in there without having any pain or condition and that it was harmless.



That's what my urologists says as well. Since August 2017 (when it was still only urethritis not prostatitis), I had once a positive result for Mycoplasma. As I was very surprised about the result (had taken many cultures already since November 2016), I went on not taking antibiotics for it and got another test a month later and it showed negative for it again.
Since then my cultures (semen/urine/urethra swap), sometimes are altogether negative, or show Enterococcus faecalis.
Have tried a couple of antibiotics since, but didn't get any relief, even when they were sensitive.

So now at the moment, I asked two urologists, one who says that the problem is linked to a dormant Mycoplasma infection (one positive test in Aug2017), is sure that the Enterococcus isn't causing the problem. Taking Moxifloxacin now for 26 days out of 4 weeks, but didn't help so far.

The 2nd urologist thinks that the Enterococcus is the problem (plausible as it's the only one which keeps recurring in the cultures). But the Ampicilin/Sulbactam (which was Sensitive on the culture) he put me on didn't help.
Enterococcus faecalis culture was only shown Intermediary for Moxifloxacin.

So either way 26 days in, symptoms are still there, not sure if I should stop here or do another 2 weeks of Moxilfoxacin,

Also no clue what to do next, as again my urologists have ran out of ideas how to get rid of it. The whole thing should be bacterial, as I had these problems starting immediately after unprotected Sex (discharge, burning etc.). 1,5 years of having urethral problems doctor made a cystoscopy and since them the prostate problems are also there, which speaks that the bacteria got pushed from urethra into prostate during the procedure.

Any idea anyone?


Wed Jan 30, 2019 1:46 am
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Joined: Tue Jun 16, 2015 11:12 pm
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Post Re: List of Medications for Bacterial Prostatitis
Excellent antibiotic chart I link in this post "Medications - Antibiotics Painkillers Inflammation"

"Devil In Your Balls" Self-Help Blog Prostatitis / Epididymitis Pain

I understand where many of you have been regarding prostate discomfort.


Sun Feb 24, 2019 9:00 am
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