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After a couple of weeks of discomfort and a few negative tests (blood and urine), I tested positive for an epidermal staff infection of the prostate (positive cocos gram, staphylococcus epidermis). My doctor prescribed Amocillin 875mg with Clavulanic Acid 125mg for an initial period of 4 weeks. I understand that a prostate infection is particularly difficult to treat and that the particular staff type of infection I have is quite resilient and q treatment of 6 weeks or longer is often required.As far as I can understand, S. epidermidis strains are often resistant to antibiotics, including penicillin, amoxicillin, and methicillin. Wikipedia states, "As S. epidermidis is part of the human normal flora, it has developed resistance to many common antibiotics such as methicillin, novobiocin, clindamycin, and benzyl penicillin." Amoxicillin is effective against Staphylococcus species that don't produce beta-lactamase; however, neither amoxicillin nor amoxicillin/clavulanate is effective against methicillin-resistant staph epidermidis. My first question is: how do I know if this particular staff infection is methicillin sensitive? Second, when should I begin a different treatment and what antibiotic(s) should be prescribed and for how long?My research has led me to believe that best treatment for Staphylococcus Epidermidis deep infection is (3) :Vancomycin IV q 12 h +/- Rifampin 3- bid IV/PO +/- Gentamicin 3-5 mg/kg/d IVOr with one of these three:1. Linezolid (Zyvox) 600 mg IV/PO bid + Rifampin +/or Gentamicin or with 2. Daptomycin IV 4 mg/kg/d + Rifampin +/or Gentamicin.3. Quinupristin / Dalfopristin (Synercid) I have been on the antibiotics for three weeks and feel no relief. I really don’t want this acute infection develop into a chronic infection and it seems like being aggressive in treatment is important. I am in a developing country and the medical training here is not the same standard as other places in the world.Please I need to know what treatment I should take.Thank you in advance,Erik
Optional Information: Person's Gender: Male Person's Age: 33 Already Tried: After a couple of weeks of discomfort and a few negative tests (blood and urine), I tested positive for an epidermal staff infection of the prostate (positive cocos gram, staphylococcus epidermis). My doctor prescribed Amocillin 875mg with Clavulanic Acid 125mg for an initial period of 4 weeks. I understand that a prostate infection is particularly difficult to treat and that the particular type of infection I have is quite resilient and treatment of 6 weeks or longer is often required. As f
Thanks for your question. If I don't respond to you immediately, it is because I am either in the OR or traveling. I WILL get back to you ASAP.Unfortunately, I see that you have lots of misinformation based on your internet research that has led you to inaccurate conclusions. You do not need any of the potent antibiotics you listed. Staph epi is a common bacteria and most commonly is not methicillin resistant. Staph aureus is what we get concerned about being methicillin resistant.Prostatitis typically requires a 4 week course of antibiotics, not 6 weeks.My first question is: how do I know if this particular staff infection is methicillin sensitive? - Your doctor would know this based on the results of the urine culture and the antibiotic sensitivity profile that comes with it.Second, when should I begin a different treatment and what antibiotic(s) should be prescribed and for how long?- If you are net better by now, you need to ask your doctor to look at the antibiotic sensitivity profile to see if the infection is sensitive to either ciprofloxacin or trimethoprim/sulfamethoxazole. These antibiotics have the best penetration into the prostate and can treat the staph epi you have if it is sensitive to those antibiotics. Hope this helps.
I am in a a jungle city in Peru so I am a bit worried about the quality of the doctors - there is only one urologist. The lab does seem to be very OK and I can tell you the results. Some parts might be in Spanish but since both the Spanish and English words are derived from Latin, they should be very similar.In terms of the antibiogram secreciones - the test states:AMPICILIN - RESISTANTAMOXCILIN - SENSIBLECLINDAMICIN - RESISTANTCEFOTAXIM - RESISTANT CEFADROXIL - RESISTANTERITROMICINA - RESISTANTGENTAMICINA - ITERMEDIATESULFATRIMETROPIN - RESISTANTPENICILIN - SENSIBLELINCOMICINA - RESISTANTBased on this info, could you tell me if if the infection is sensitive to either ciprofloxacin or trimethoprim/sulfamethoxazole?I thought the staph aureus was less likely methicillin resistant based on the following: In an excellent article of Jukka Hyvarinen et al. (2), 570 Staphylococcus spp. isolates were tested for susceptibility to oxacillin and 19 other antimicrobial agents. Of the 238 Staphylococcus Epidermidis isolates, 58 % were identified as methicillin - resistant in vitro . Of the 332 Staphylococcus aureus isolates only 1 (0,3%) was phenotypically resistant to methicillin.The percentage (%) of Staphylococcus Epidermidis isolates resistant to the 20 tested antibiotics was : Oxacillin (58%) , Penicillin (82 %), Amoxicillin/ClavulanicAcid (34 %), Cephalothin (4 %),Cefuroxime (31%), Cefotaxime (20%), Imipenem (46%) , Gentamicin (46 %) , Tobramycin (57%) , Netilmicin (16 %), Ciprofloxacin(23 %), Ofloxacin (21%), Erythromycin (36%), Fusidic Acid ( 27% ) , Clindamycin (34 %), Cloramphenicol (19 %), Rifampin (4 %), Vancomycin ( 0 % ) , Co-trimoxazole(62%), Trimethoprim (53%) ; From this data we conclude that only vancomycin and to some extent rifampin and cephalothin are suitable for the treatment of bacterial prostatitis caused by Staphyloccocus epidermidis. However, rifampin cannot be used as monotherapy since microbial resistance to it seems to develop rapidly. I know one article on the internet can provide extremely inaccurate information, especially to someone who knows next to nothing about medicine...with this in mind, can I stop with my worries about staph epi being highly resistant. I came across this information from various sources. Should I then continue wit the current round of antibiotics until the end of the 4 weeks and the move on the other options you mentioned if they are reactive? I have seen no improvement after 18 days. Sorry, bur I have certain psychological tendencies that make it difficult for me to concentrate on anything else (i.e. hypocrondriac/OCD) - not officially diagnosed. I guess that it why I am on this right now.Please any help you can provide. I am seriously worried this will become chronic and it is quite debilitating to ones quality of life. I am scared.Thanks again...
Relist: Answer came too late.
Hello there,Please be patient, as I may be in the operating room, with a patient, or driving but will get back to you ASAP.
Hi, let me try to help you. Unfortunately this infection is not sensitive to Cipro or Bactrim (sulfa). I would not worry too much about Staph epi being resistant as it is not a very virulent bug. It is actually a common skin contaminant. The good news is that this bacteria is sensitive to amoxacillin which is a very common and well tolerated antibiotic tablet. This is what you need. I recommend 4 weeks of amoxacillin 500mg twice/day. This should do the job and do not worry about resistance as you have the sensitivities right there. Hope this helps.
(I appologize if I am being repetative - I believe my question is now more exact)
After a couple of weeks of discomfort and a few negative tests (blood and urine), I tested positive for an epidermal staff infection of the prostate (positive cocos gram, staphylococcus epidermis). My doctor prescribed Amocillin 875mg with Clavulanic Acid 125mg for an initial period of 4 weeks. I understand that a prostate infection is particularly difficult to treat and that the particular staff type of infection can be difficult to cure. I have been on the antibiotics for three weeks and feel no relief. I really don’t want this acute infection develop into a chronic infection. I am in a developing country and the medical training here is not the same standard as other places in the world. The lab does seem to be OK and I can tell you the results to help prescribe the correct antibiotic.
In terms of the antibiogram secreciones - the test states:
AMPICILIN – RESISTANT
AMOXCILIN – SENSIBLECLIND
AMICIN – RESISTANT
CEFOTAXIM - RESISTANT
CEFADROXIL – RESISTANT
ERITROMICINA – RESISTANT
GENTAMICINA – ITERMEDIATE
SULFATRIMETROPIN – RESISTANT
PENICILIN – SENSIBLE
LINCOMICINA – RESISTANT
My own research has led me to believe that Quinolones are the most effective treatment of prostate infection because of their excellent penetration into prostatic tissue; however Amoxicillin penetration into the prostate is questionable. Is this accurate?
When should I begin a different treatment and what antibiotic(s) should be prescribed and for how long?
How do I know if this particular staff infection is methicillin sensitive?
Is my particular infection sensitive to either ciprofloxacin or Levofloxacin?
What about Avelox or Tequin? (I read these can be effective in gram positive infections.)
What about Biaxin, Zithromax? Or perhaps a tetracycline? Or Vancomycin?
Please, I am very concerned and need to know what treatment to take. Thank you so much in advance, Erik
Yes you are correct that quinolones are definitely best for prostate infections. Amoxicillin has very questionable penetration. Cipro is the best antibiotic for prostatitis. If you have finished at least 3 weeks of antibiotics such as augmentin and are not better then Cipro would be recommended for 3-4 weeks. It is sensitive to methicillin because the biogram shows susceptibility to penicillins and methicillin is one. Tequila is fine but I've never heard of anyone taking Avalon for prostatitis as this is overkill. Biaxin, Zithromax, and tetracycline are not good for prostate infections. Hope this helps and please do not forget to hit the green accept button so I get credit for working with you. Thanks.
One quick follow up question.Another urologist on just answer wrote me the following, "Unfortunately this infection is not sensitive to Cipro or Bactrim (sulfa)."This is based on the same information I provided you. Who is correct? Can I take cipro for my infection?Thank you...
I will be happy to help you further and answer anymore questions you have as I see several patients a week with prostatitis and your same symptoms. Please hit the green accept button so I get credit for working with you.thanks.
Experience: Board Certified in Urology, Fellowship trained
Hello, here are my thoughts. Cipro is not sensitive to the bacteria that was cultured with the results you provided above. Based on those sensitivities, augmentin or amoxicillin should work to treat the infection. If you finish your course of 4 weeks and you are not better, I think the next step would be to take cipro for a month although it is not sensitive. I do not see the point of continuing augmentin when you are not improving. Cipro should treat your prostatitis and I would expect it to work. Hope this helps.