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Urology/Bacterial prostatitis antibiotic options?


Hello Dr.

I am a 34 year old male. Long story short. After over a year of pain and wrong diagnosis. I was finally seen and treated by a respected urologist. I was diagnosed with prostatitis. Then took a expressed prostatic secretions test. (I was told bacteria was found) And was given 21 days of Augmentation. (I did not want to take Cipro due to its side effects.) Well it seemed to do the trick. After a follow up it was recommended that I take a prostate ultra sound. That showed calcifications of the prostate. Fast forward 6 months and it seems that my symptoms have returned after doing very physical work at my job.

My questions are is there a chance that the antibiotics did not kill all the bacteria off last time and they have returned? Or am I now in the none bacterial prostatitis club due to calcifications? Also what other antibiotics would you recommend effective other than anything in the Cipro class. If the infection has returned.

I will be seeing my urologist in a week. Thank you Dr. In advanced.


Yes, there is a chance there could be residual bacteria.  You probably now have chronic bacterial prostatitis.  Calcifications in the prostate are common with or without prostatitis.

The usual antibiotics used for prostatitis include cipro, levaquin, doxycycline, minocycline and sulfa/trimethoprim.  We don't use augmentin much anymore due to resistance and GI side effects.

Cipro has, in my opinion, fewer side effects than the augmentin you already took.

Here are some other suggestions:

Typical Treatments for Prostatitis Include:

Avoid caffeine which irritates the prostate and bladder.
Hot sitz baths.  Sitting in a very hot tub for 10 minutes really seems to reduce pelvic pain, inflammation and discomfort.  We recommend twice or even three times a day for severe cases or flare-ups, but at least once a day for most prostatitis patients.
Avoid hot spices which tend to irritate the prostate.
Avoid sitting on hard surface; use an inflatable donut to spread the pressure away from the prostate.
Use NSAIDs like ibuprofen (Motrin, Advil) or naprosyn (Aleve) to help reduce discomfort and inflammation.
Antibiotics as prescribed by your physician.  Typically, at least 4-6 weeks minimum is required.
Alpha blocker medications such as tamsulosin and alfuzosin will help relax muscle tension in the prostate and improve urinary flow.
Avoid high potassium foods that some people are sensitive to and which can be irritating.
Less alcohol and smoking.
Use quercetin which is a natural anti-inflammatory herbal supplement that has been shown to help reduce inflammation in the prostate.


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Stephen W. Leslie, MD


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


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.

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

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.

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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