Balanitis is the infection of the foreskin and head of the penis characterized by soreness, irritation and discharge that can last for 2 to 3 days after intercourse. Balanitis may occur because of infectious and noninfectious causes. Poor hygiene, especially in uncircumcised men and those with reduced immunity, is a major contributing factors. Antibiotics pills and creams may be used to treat balanitis if bacteria or fungi are the suspected causes. Surgery and circumcision may the best options to treat severe cases.
Clindamycin is an antibiotic that belongs to the lincomycin family and is effective against balanitis caused by anaerobic bacteria, which are bacteria that thrive well in the absence of oxygen. Clindamycin acts by slowing and stopping the growth of the bacteria. As per the John Hopkins Point of Care Information Technology Center, 2 percent clindamycin cream should be applied two times daily until the infection is resolved or as prescribed by the physician. Common side effects include burning, itching, rash and blisters at the site of infection.
Mupirocin is another antibiotic that is available in ointment form and is used to treat balanitis caused by Staphylococcus and Streptococcus species. The affected area of the skin is washed, and a small amount of mupirocin ointment is applied three times a day for 1 to 2 weeks. According to MedlinePlus, mupirocin may cause side effects that include burning, stinging, pain, itching or rash, and it is important to talk to a doctor if these symptoms do not go away.
Oral administration of cephalosporins, such as cephalexin, is recommended to treat balanitis caused by Staphylococcus or Streptococcus, especially if the infection has spread to other parts of the body. Cephalosporins such as ceftriaxone or cefixime can be used to treat balanitis caused by Niesseria gonorrheae. Cephalosporins are usually administered four times a day for 7 days. Common side effects include nausea, vomiting, diarrhea and upset stomach.
Macrolides, such as erythromycin and azithromycin, are generally taken orally to treat balanitis caused by a wide range of bacteria, including Staphylococcus species, Streptococcus species and Neisseria gonorrheae. Macrolides act by preventing the synthesis of new proteins in the bacterial cell and are usually prescribed for 7 days to be taken two times daily. Macrolides are fairly well tolerated, and common side effects, according to the Mayo Clinic, include diarrhea and abdominal pain.
Azole Family Drugs
Azole family drugs are effective against fungi and are used to treat balanitis caused by fungi such as Candida. Drugs such as clotrimazole, fluconazole and miconazole are available in cream and tablet form and can be prescribed according to the condition of the patient. In fact, an article published in the April 1996 edition of Genitourinary Medicine states that a single dose of fluconazole is equivalent in efficacy and safety to topical clotrimazole cream applied for 7 days. Side effects of most azole family drugs include nausea; vomiting; upset stomach; and blisters, itching and redness at the site of application.
- John Hopkins POC-IT Center: Balanitis
- MedlinePlus: Mupirocin
- MayoClinic.com: Azithromycin (oral route)
- "Genitourinary Medicine"; Comparison of the efficacy and safety of oral fluconazole and topical clotrimazole in patients with candida balanitis.; A Stary, J Soeltz-Szoets, C Ziegler, G R Kinghorn and R B Roy; April 1996