Chronic non-bacterial prostatitis but Zithromax helps

[Ausged]

I have suffered from non-bacterial prostatitis for about 2 years. I have what appears to be the classic symptoms, penis pain (in the head and along the urethra), pain around the perineum, redness at the penis tip, soreness in the bladder, urgency to urinate then only small amounts at times. I have had all the tests, blood, 3 part urine with prostate massage, seaman, swab taken from penis x 3. All these tests came back negative, except for the very first swab which showed traces of chlamydia.

I have taken multiple courses of antibiotics, Sulfamethoxazole, Doxycyclin, Ciprofloxacin and Azithromycine, also various medications like "Prostagut", zinc, etc. During this time I have experienced this problem wax and wain, and at times disappear completely. I can totally exclude recurrent infection because since  the positive Chlamydia test I have used a condom and also have changed girlfriends several times.

I have come to the conclusion that when I take Zithromax  (Azithromycine), I feel much better, within a day. The redness disappears, the urgency dissipates and most of all the pain recedes, almost like a pain killer. I performed an experiment last year where I took a reasonable course of Zithromax and performed a self prostate massage all though the course, I experienced a complete hiatus from the pain for three months. My question is, is there something in the Zithromax that is makes me feel better or is it acting on a mysterious bacteria that cannot be identified?  The reason why I ask this is that it is so much more expensive that other antibiotics. Thanks.

[Kevin Pho, MD]

It is possible that the bacteria is sensitive to the Zithromax.  To be sure of this you may want to culture the prostatic secretions.  This would identify what bacteria is present and test it to make sure it is sensitive to a variety of antibiotics.  

Once you have the sensitivity panel of the bacteria, you should be able to identify which antibiotic is effective against the infection.  There is a possibility that it may be sensitive to some antibiotics and resistant to others.

You may also want to consider a transrectal ultrasound if the symptoms do not improve.  This can image the prostate and visualize any abscess that are not affected by antibiotics.

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.

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