What to do about anterior endodontitis

Prostatitis is mostly a male disease that often occurs among middle-aged and elderly men. It requires a long period of treatment after it occurs. It is not a disease that can be completely cured overnight. At the beginning, patients must use antibacterial treatment according to their symptoms. There are many antibacterial drugs that can be used to treat prostatitis. The effects are very significant and will not cause many complications.

1. Antibacterial treatment

The discovery of pathogenic pathogens by culture of prostatic fluid is the basis for selecting antibacterial drug treatment. If patients with non-bacterial prostatitis have signs of bacterial infection and are ineffective with conventional therapies, they can also be treated with antibiotics appropriately. When choosing antibacterial drugs, attention should be paid to the existence of a prostate-blood barrier composed of a lipid membrane between the prostate acini and microcirculation. This barrier prevents the passage of water-soluble antibiotics and greatly reduces the therapeutic effect. When prostate stones are present, the stones can serve as shelter for bacteria. The above factors make it difficult to treat chronic bacterial prostatitis, which requires a longer course of treatment and is prone to recurrence.

At present, many people advocate quinolones such as ofloxacin or levoofloxacin. If it doesn't work, continue to use it for 8 weeks. If the disease relapses and the bacterial species remains unchanged, preventive doses should be used to reduce acute attacks and reduce symptoms. If long-term use of antibiotics induces serious side effects, such as pseudomembranous colitis, diarrhea, growth of intestinal drug-resistant strains, etc., the treatment plan needs to be changed.

Whether non-bacterial prostatitis is suitable for treatment with antibacterial drugs is still controversial in clinical practice. “Patients with "sterile" prostatitis can also use drugs that are effective against bacteria and mycoplasma, such as quinolones, SMZ-TMP or TMP alone, in combination with tetracyclines and quinolones or at intervals. If antibiotic treatment is ineffective and sterile prostatitis is confirmed, antibiotic treatment will be discontinued. In addition, the purpose of treatment can also be achieved by sealing the prostatic urethra with a double balloon catheter and injecting antibiotic solution from the urethral cavity back into the prostatic duct.

Type I mainly uses broad-spectrum antibiotics, symptomatic treatment and supportive care. Type II recommendation is to give priority to oral antibiotics and select sensitive drugs. The course of treatment is 4 to 6 weeks, during which the patient's efficacy should be evaluated in stages. Type III can be treated with oral antibiotics for 2 to 4 weeks before evaluating the efficacy. At the same time, non-steroidal anti-inflammatory drugs, α-receptor antagonists, M-receptor antagonists, etc. are supplemented to improve urinary symptoms and pain. Type IV requires no treatment.

2. Anti-inflammatory and analgesic drugs

Non-steroidal anti-inflammatory drugs can improve symptoms. Generally, indomethacin is taken orally or as a suppository. Traditional Chinese medicine, which uses anti-inflammatory, heat-clearing, detoxifying, and hard-softening drugs, also has certain effects. Allopurinol can reduce the concentration of uric acid in the whole body and prostatic fluid. It can theoretically serve as a free radical scavenger and can also scavenge reactive oxygen species, reduce inflammation and relieve pain. It can be regarded as an optional auxiliary treatment method.