Patient's question:
Patient Age: 27Detailed Condition and Purpose of Consultation:
Today, I had a prostatic fluid test, and the results were: FAT: (±) WBC: (+++++) GV: (-) The smear test of the secretion showed a few G+ cocci. The doctor said it was quite serious and that if untreated, it could lead to the loss of sexual function. Treatment at his clinic could cure it within a few days, but the cost is high.
First Follow-up Question: Is Compound Sulfamethoxazole and Trimethoprim the same as Sulfamethoxazole and Trimethoprim? Is its side effect very severe?
Doctor's answer:
Hello: According to your condition, active treatment should be initiated. 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 suitable, it is important to promptly select adequate and highly effective broad-spectrum antimicrobial drugs 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 cotrimoxazole, can be used, as it achieves high concentrations in the prostate and is the preferred oral medication. Dosage: Twice daily, with 2 tablets per dose (each tablet contains 80 mg of TMP and 400 mg of SMZ), taken orally. If the bacteria are sensitive to this medication after treatment and symptoms improve, it can be continued for 30 days to prevent the condition from becoming chronic.
For patients who cannot take cotrimoxazole, Gentamicin (3–5 mg/kg/day) or Tobramycin (3 mg/kg/day) can be administered three times daily via intramuscular injection, combined with Amoxicillin (1 gram 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.