Patient's question:
My testicles are very painful after ejaculation. The hospital's test results state inflammatory changes. I'm very scared. What should I do about this condition?Doctor's answer:
Hello:Acute prostatitis can be treated with sensitive antibiotics based on urine or prostatic fluid bacterial culture results. However, if bacterial culture results are not available promptly in the early stage of treatment or if conditions are not met, it is important to promptly select an adequate and highly effective broad-spectrum antimicrobial agent to control the progression of the disease. Currently, cephalosporin antibiotics are commonly used. Clinically available options include Fosfomycin (1.5 grams per dose, twice daily, dissolved in 100 milliliters of liquid for intravenous infusion) or Cefalexin (2.0 grams per dose, twice daily, for intravenous infusion).
If these medications are not suitable, a combination of sulfamethoxazole (SMZ) and trimethoprim (TMP) tablets, such as Trimethoprim/Sulfamethoxazole (Trimethoprim/Sulfamethoxazole compound), can be used. This is the preferred oral medication because it achieves high concentrations in the prostate. Dosage: Take 2 tablets twice daily (each tablet contains 80 mg TMP and 400 mg SMZ). If the bacteria are sensitive to the medication after treatment and symptoms improve, continue the medication for 30 days to prevent the condition from becoming chronic.
For patients who cannot take Trimethoprim/Sulfamethoxazole, Gentamicin (3–5 mg/kg/day) or Tobramycin (3 mg/kg/day) can be administered via intramuscular injection three times daily. Additionally, Ampicillin (1 gram) can be given via intravenous infusion every 6 hours for one week. Afterward, medication selection should be based on bacterial culture and drug sensitivity tests. Once the condition improves, oral medications such as Norfloxacin can be used to continue treatment for 30 days.