Patient's question:
My testicles are very painful after ejaculation. The hospital's test report says there are inflammatory changes. I'm very scared. What should I do about this disease?Doctor's answer:
Hello:Acute prostatitis can be treated with sensitive antibiotics based on urine or prostatic fluid bacterial culture results. However, when bacterial culture results are delayed in the early stages of treatment or when conditions are not available, it is important to promptly use sufficient 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, intravenously administered in 100 milliliters of liquid) or Cefalexin (2.0 grams per dose, twice daily, intravenously administered).
If these medications are not suitable, a combination of sulfamethoxazole (SMZ) and trimethoprim (TMP) tablets, such as Trimethoprim-Sulfamethoxazole (Co-trimoxazole), 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 of TMP and 400 mg of SMZ). If the bacteria are sensitive to the medication and symptoms improve after treatment, continue taking it for 30 days to prevent it 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, combined with Amoxicillin (1 gram intravenously administered every 6 hours) for one week. Afterward, select the appropriate medication based on bacterial culture and drug sensitivity tests. Once the condition improves, switch to oral medications such as Norfloxacin for continued treatment for 30 days.