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|Author:||Metanoia [ Thu Feb 02, 2017 2:44 am ]|
When my urologist first diagnosed me with acute bacterial prostatitis, he said “now that bacterial resistance to fluoroquinolones has become so widespread, he now recommends Bactrim as his preferred initial treatment”.
As I dug into research regarding this therapy, I discovered an interesting paper on “Treatment of Bacterial Prostatitis” that dug deep into the fluoroquinolone/sulfa debate.
http://prostatitis.org/redirect.php?lin ... rostatitis
I was shocked to find a short blurb stating “The prostatic concentration of sulfamethoxazole is much lower, raising doubts that it synergizes with trimethoprim.”
Bactrim is a combination of two different drugs. Sulfamethoxazole, and trimethoprim (SMZ-TMP), which are supposed to complement each other in eradicating bacterial pathogens.
The sulfamethoxazole component of the medication is substantially more allergenic than the trimethoprim component, which begs the question… If trimethoprim penetrates the prostate, but sulfamethoxazole does not, why not use trimethoprim (which is far less allergenic) as a stand alone medication?
Well, in Europe, stand alone trimethoprim IS frequently used for female UTI’s, and as a result, just as with fluoroquinolone use, bacterial resistance has become common.
http://prostatitis.org/redirect.php?lin ... 66.article
"Trimethoprim 'close to obsolete' as antibiotic resistance soars"
So when you’re taking Bactrim for prostatitis, you’re taking one highly allergenic drug that apparently doesn’t penetrate the prostate all that well, and a second med, that while penetrating the prostate well, has a remarkably sharp increase in bacterial resistance to it.
Bottom line… If your culture and sensitivity shows your bug is sensitive to the sulfamethoxazole component of Bactrim, but not to trimethoprim, Bactrim may not work for you as sulfamethoxazole doesn’t penetrate the prostate well. If your bug is sensitive to trimethoprim, a stand alone TMP prescription may help you avoid the allergenic potential of the sulfamethoxazole/SMZ component of Bactrim.
If you don't have a proper semen culture and sensitivity done, beware; as the SMZ component of Bactrim is highly allergenic and doesn't penetrate the prostate well, and the TMP component of Bactrim has shown a remarkable increase in bacterial resistance to it's effectiveness.
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