Is cotrimoxazole effective for chronic prostatitis?

In real life, chronic prostatitis is a common physical disease for many men. Chronic prostatitis can easily affect the health of the body and easily lead to some complications, which have a great impact on the body. There are many kinds of drugs for the treatment of chronic prostatitis. You can choose co-trimoxazole, which has therapeutic effects.

There are two treatment goals for chronic bacterial prostatitis: one is the so-called "curative" treatment, and the other is "suppressive" treatment. Curative treatment is to eliminate the infection focus in the prostate and eliminate the cause of the persistent bacteriuria. Suppressive treatment is to inhibit the growth of bacteria in urine through antibacterial drugs, which can often completely eliminate the patient's clinical symptoms and greatly reduce the risk of serious diseases caused by prostate infection lesions.

Using antibiotics to eliminate bacterial infection lesions requires that the appropriate antibiotics can reach sufficient concentrations at the infection site. Unlike acute prostatitis, chronic prostatitis has a stronger tolerance to antibiotic treatment, which requires the selection of drugs that can fully diffuse into the prostate gland, that is, they are fat-soluble and do not bind to serum proteins. However, many clinical studies have reported that almost no drugs can truly cure chronic bacterial prostatitis.

Co-trimoxazole is currently the most widely used and most effective drug for the treatment of chronic bacterial prostatitis. This is because sulfamethoxazole has a high fat solubility and is an alkaline drug. Its concentration in the prostate is 2 to 3 times higher than that in plasma. Although the content of sulfamethoxazole in prostatic fluid is not as high as that in plasma, the half-lives of the two are similar, and combined use has a good synergistic effect on Gram-negative bacteria. Patients who take co-trimoxazole orally for 4 to 16 weeks can generally achieve a cure rate of 30% to 40%, which is a significant improvement over the cure rate of short-term treatment.

According to the principle of individualization, a comprehensive and effective detailed plan for the prevention of prostatitis is formulated for specific patients and supervised and implemented, which may achieve good results. Prostatitis patients can be completely cured after formal and systematic treatment. Although the pathogens in the prostate have been completely eliminated in the short term after the cure, it does not mean that the prostate tissue damage caused by the infection has been completely repaired. During the recovery period of the disease, the prostate may often be in a sub-healthy state, and it is easier to be infected with pathogens again or cause obvious congestion of the prostate again than the general population, causing the symptoms of prostatitis to reappear.

Preventing reinfection with pathogens is an issue that doctors and cured patients need to pay special attention to. Some doctors recommend the long-term use of sensitive antibiotics in small doses for preventive treatment. In addition, the appropriate use of α receptor blockers can also significantly improve the blood circulation of the prostate and the tension of the tissues around the prostate, eliminate the reflux of urine in the prostate during urination, and thus reduce the recurrence and reinfection of prostatitis. Functional damage to the pelvic floor muscles may be one of the culprits of prostatitis. Biofeedback technology can guide patients to recognize and correct the contraction of the pelvic floor muscles during urination, perform contraction/relaxation exercises, restore muscle activity to the normal dynamic range, encourage continuous muscle function exercise in the family, voluntarily relax the pelvic floor muscles, and gradually increase the urination interval time.