Dual treatment modalities for Prostatitis

[Tom A]

I have suffered recurrent bouts of prostatitis for 4 years. I was unable to sustain treatment with Levaquin because of severe psychotic effects.  Treatment with Cipro seems to become less effective with each recurrence. I have used Bactrim with some effect from time to time, hoping to reserve Cipro for those few (but awful!) occasions when Bactrim failed.

My question is this.  Is there any counterindication against using Bactrim and Cipro in combination?  My own urologist says he never heard of anyone doing this and is therefore hesitant about pursuing such a treatment.  What do you think of the synergy between the two drugs?

Thank you for your time.  As I'm sure you know very few men die of Prostatitis, but there are times when many of us wish we could!

[Kevin Pho, MD]

Hello - thanks for asking your question.

Generally using two antibiotics in combination should not be more effective.  If the bacteria is sensitive to each of the antibiotics, using both of them together should not be more effective than using each one of them alone.  

Using a drug interaction database, there should be no direct interaction between Bactrim and Cipro.  Each has GI side effects, so there may be an increase probability of side effects such as upset stomach, nausea or diarrhea.  

Typically with chronic prostatitis you have to make sure that the bacteria is sensitive to the antibiotic.  This should be done with prostatic secretions before and after prostatic message.  Treatment is typically 4-12 weeks.  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.

[bws]

Tom, there aren't any drug-drug interaction between these medications specifically or and they be shouldn't be any better if used together, as dr. kevin said.  However, incase your MD or pharmacist didn't tell, I just wanted to let you know that you should drink plently of fluids (not carbonated) since they both can cause crystalluria.  Bactrim specifically needs pleny of water.  Also, both of those medications can cause sensitivity to sunlight (especially bactrim) so you should wear sunscreen when out in the sun while your taking these medications.  Lastly, remember not to take the cipro within 1-2 hours (1 hr before, 2hrs after) of any antacids, milk, yogurt, iron, multi-vit, etc.

On a side note, I know a patient who has actually been on cipro everyday for the last 1 year for his prostatitis.  I wouldn't prefer the use of antibiotics so liberally, but that is the only thing he has found to work.