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Question
Dear Dr  Leslie
,
I have been suffering from prostatitis after treatment to remove the bladder stone .I was on ciprofloxacin for 12 days, but I had a severe pain in my joints .However, they put me on Trimethoprim for last 6 days .The
Ciprofloxacin nearly cured the problem, but since I have been on Trimethoprim 200mg twice daily my condition is getting as before nagging pain in penis, lower back ,lower stomach ,just above bladder pain ect .
Q1)- I am on Trimethoprim 200mg x2 daily, is this antibiotic same as  trimethoprim- sufamethoxazole. Because my tablets information does not mention sufamethoxazole .I was wondering if I have been treated with the incorrect antibiotic for prostatitis ??
Q2) - Please what other medication you would recommend in replacement of trimethoprim. As such ,this antibiotic seems not working as good as ciprofloxacin
I am most grateful for your kind answers
Regards
Essi

Answer
Essi:

Trimethoprim is NOT the same as trimethoprim/sulfa.  Since the sulfa portion does not penetrate the prostate, it is not necessary for the treatment of prostatitis.  Antibiotic treatment for prostatitis can take at least 6 weeks and often longer.

It would be nice to go back to the cipro class of drugs since they worked well.  Perhaps you could try levofloxacin.  It's chemically a little different from cipro but still works well in prostatitis and is in the same class.

If not, we can also try doxycycline, a tetracycline.  This has also worked in prostatitis.

Bladder stones often indicate prostate enlargement.  If this is an issue, you might benefit from a medication like tamsulosin that improves urinary flow in men.  Also try some hot sitz baths and avoid caffeine/hot spices as they can worsen prostatitis symptoms.  

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Stephen W. Leslie, MD

Expertise

Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.

Experience

Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

Organizations
American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Publications
Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Education/Credentials
Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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