Thank you for your query at DoctorSpring.com
Your email clearly expresses that you have been through a difficult time with your condition, chronic bacterial prostatitis (due to Methicillin resistant Staph aureaus).
To answer your query of whether immune stimulatory drugs can be used; the answer is no because they drugs are used in serious conditions like cancer where levels of important cells in your body such as red blood cells, white blood cells have dropped. Your condition is unlikely the result of a weakened immune system unless you have a report stating that your white blood cell count is lower than 4000.
You do have a few options which I would like to list out for you:
Hope this helps, you can follow up with any queries that you may have,
- Further treatment should be guided by urine culture results. Since you are now beginning to failure therapy with Bactrim, you can instead try a 12-week course of therapy with fluroquinolones ( ciprofloxacin at 500 mg or ofloxacin at 400 mg) administered twice daily or gatifloxacin/moxifloxacin at 400 mg given daily. This drug is particularly valuable if < 35 years and sexually active with multiple partners, because it also has activity against chlamydial and gonorrheal organisms.
- There is also an option to use other drugs such as carbenicillin or doxycycline or injections of gentamicin given IV or directly into the prostate.
- There are a few options to select from which may have to try out one at a time to see which one offers you relief. You can use terazosin at 1-10 mg OR Saw palmetto which is a herbal supplement OR quercetin which is found in green tea, onions and oranges.
- Daily sitz baths and perianal massage may help with the discomfort associated with chronic prostatitis.
- Surgery is usually not indicated for chronic prostatitis. However, in cases such as yours, TURP or TUVP may remove a nidus of infection. This nidus may be in the form of prostatic stones which are usually visible on transrectal ultrasonograms.
- Also it would be prudent to use protection from now onwards during sexual encounters so that an organism is not reintroduced and precipitate an attack.
Patient replied :
For the 2.5 years I have dealt with this it always is worst in early am (5-6) with a specific pointe of soreness 1inch or so to the lesft of my belly button and two inches down. When I awake this soreness is accompanied by considerable nausea. If I push on the spot it seems too have a connection to my prostate. This has occurred during last 2.5 years but would go away on bactrim when it worked and remain away for monthsI have had two colons copy's and barriuMm X-rays..gi is clear.
it seems to me as a lay person that either my nightly production of testosterone acts as an immunosuppressant although it should likely suppress inflammation too.
My last two PSA were 0.7 and 0.8
why am I sickest in the am and the pain expression more in abdomen than prostate.
i have taken 4 Advil at 3 am and it does not change the outcome. Usually the pain improves and nausea to some degree as day progresses. It often seems as though food helps the nausea
thanks so much
ps if minocycline was sensitive would doxycycline be also? Minocycline caused hypothyroid and irregular heartbeat. Is ceftin anti mrsa?
Thank you for the follow up Paul.
The morning soreness that you're feeling is most probably due to the overnight prostatic secretions those are accumulating and the pain is being referred to the abdomen. With a testosterone surge, the prostate secretions increase in the night time, providing a nidus for the bacteria to multiply.
I feel you should start yourself immdiately on Tab. Ofloxacin 400 mg twice daily for a 12 week course.
Doxycycline and minocycline are different. Minocycline can cross the blood brain barrier and cause more side effects. Doxy is more safer and better for urinary and prostatic infections.
I also advise you get sitz baths and peri anal massage regularly to get rid of the secretions, till you're on your antibiotics.
Yes Ceftin is 5th generation cephalosporin, active against MRSA.
Finally please do get the transrectal ultrasound and share your reports. Based on that i can guide you further
All the best.
Patient replied :
You are unbelievabley knowledgeable and kind. Do you do videos conferencing and treat onlline?
I have no problem paying for more detailed consultation. Please advise.
I have orrginal diagnosis and susceptability and a trans rectal color utlrasound.
In order which would you say has best penetration and coverage, Oflaxacin, Doxocylcine and Ceftin.
I know Minocyline was tested for susceptability and was susceptible.
Thank you for your kind words Mr. Paul.
The only thing i want right now, is for you to get better as quickly as possible.
Unfortunately, i am not allowed to talk to via online skype consultations and these emails are the only source.
Whatever reports you have try uploading them here on your dashboard, or you can directly mail them to [email protected]
I will say purely on the basis of penetration and coverage, Doxycycline would be a better choice. Ceftin is also effective against MRSA, but it is used more in surgical prophylaxis cases. But if your sensitivity reports show Ceftin sensitive, then you can go ahead with it. I suggested Ofloxacin because compared to the other 2, it has the lowest side effects profile.
Wish you good health Paul!
Patient replied :
Final quesiton for now. Sensitivity test shows Levaquine highly resistant ( would that not limit Oflaxin) It also indicates that mincocyline is susceptible. Would that likely mean doxcycline is susecpetible too. I might try it for 6 months.
No levofloxacin ( Levaquine ) and Ofloxacin are different drugs altogether.
They both are fluoroquinolones but they have separate bacteria profiles.
For example we never give Levoflox in UTI or prostatic infections.
We prescribe either Ofloxacin or Norflox.
However if you want to try Doxycycline, you can continue for 3 months, provided you're tolerating the drug well. Make sure you take probiotics along with it to avoid vitamin deficiency. All depends on how you tolerate it. If you're not tolerating it will then as an alternative start Ofloxacin and continue for 3 month. Drug wise Doxy is more stronger with a wider spectrum but patients complain mostly of gastric side effects.
So entirely depends on how you tolerate it.
Hope i have been helpful,