Biofilm and Chronic Prostatitis

An infection that lasts longer than 3 months is usually termed as a chronic infection. It causes low grade but persistent symptoms. Such an infection is not easy for the body to fight, nor is it easy to eradicate using medication. It becomes “stubborn”, and often leaves the sufferer clueless about how to deal with it. A factor that plays an important role in infections becoming chronic is Biofilm.

What is a Biofilm?

A biofilm is a colony that consists of microorganisms that stick to each other. These microbes like bacteria, fungi and protozoa, while sticking to each other, form a slimy film or coating around their colony to protect themselves from attack – whether by the immune system of the organism they are infecting, or by medicines like antibiotics.

Biofilms usually form on a surface. It could be a living surface like human tissue or a non-living surface like a catheter. A common example of a biofilm that forms within the human body is dental plaque. Biofilms can be notoriously difficult to eradicate. This is because of how the organisms within the biofilm interact with each other.

Biofilms and Bacteria

Biofilms typically consist of multiple bacterial species like Enterococcus, Staphylococcus, Streptococcus etc., and sometimes fungi and protozoa as well. These microbes that form the biofilm communicate with each other. Research into biofilms compares them to a microorganism city. They have communication and nutritional networks that allow all the microorganisms inside to live and thrive together. Their protective layer is impenetrable by the body’s immunity and most of the antibiotics available today.

The scary part is this – these microbes don’t just live together in the biofilm. They also share their resistance patterns and genes with other bacteria living in the biofilm. So, if an Enterococcus bacterium is resistant to an antibiotic, it can pass on that resistance to a Staphylococcus bacterium that lives in the same biofilm. This means that even if you initially get an infection that antibiotics can eradicate, once it forms a biofilm with another bacterium that is antibiotic resistant, the pathogen can acquire this resistance as well and continue to infect you despite your best measures to get rid of it.

Not all infections create biofilms. Acute infections generate an immediate response from our body, and our immune systems or the antibiotics we may take after proper testing are generally able to finish these infections successfully.

However, once a biofilm is formed, pathogens can live in it and stay protected. They keep releasing planktonic (or free floating) bacteria into the body. This is what causes the low grade but persistent symptoms that are characteristic of a chronic infection. When you take antibiotics for it, these planktonic bacteria may be eradicated, providing temporary relief in symptoms. But the colony itself stays unharmed, ready to send out more planktonic bacteria, and the cycle goes on.

Role of Biofilm in Chronic Prostatitis

Prostatitis is a condition that can easily become chronic. Once bacterial pathogens infect the prostate, the body’s immunity recognises the invasion and begins to send its soldiers, the White Blood Cells (or WBCs) to fight the infection. It also causes inflammation in the infected region to be able to contain the area of infection. However, the prostate is a gland that has limited blood supply (or vascularity). If it gets an infection, the low vascularity works counter-productively for the gland, as the WBCs do not reach in sufficient quantities to eradicate the infection.

Even if antibiotics are used to treat such infections, the low vascularity limits the quantity of antibiotics reaching the prostate gland. These sub-lethal doses of  antibiotics and WBCs trigger resistance formation in the bacterial pathogens. As time passes, the bacteria stick together and attach themselves to the tissues on the inside of the prostate gland and form biofilms.

Once a biofilm is formed, the condition usually becomes chronic. Biofilms release planktonic bacteria that cause the low-grade symptoms of chronic prostatitis, but the main colony of the offending pathogens sits comfortably inside. You take antibiotics and feel better for the duration of the course because the antibiotics are killing the planktonic bacteria. But once you finish the course, the symptoms return, sometimes even a few months later, as the biofilm releases fresh planktonic bacteria. 

Here is a video of Dr John William Costerton, popularly known as the “Father of Biofilms”, explaining the role of biofilms in chronic infectious diseases. I highly recommend a watch:


Chronic prostatitis is essentially a biofilm disease, and that is why it is so difficult to treat. The key to dealing with it successfully is to find a treatment that is able to attack and completely eradicate biofilms and the pathogens hidden inside them.

21 thoughts on “Biofilm and Chronic Prostatitis

    1. Hello Salem,
      Studies have shown that phages are able to eradicate biofilms.
      I can go by my own experience of eliminating the bacterial pathogens and treating my prostatitis, which is a biofilm infection, using phages. I would say that phages are effective in dealing with biofilms.

    1. Hey Mikko,

      I did not take any biofilm disrupting foods or supplements, but they could only be helpful. What foods/supplements are you thinking of trying?

  1. Mikko

    And I’m also taking Tulsi, which – besides supposedly disrupting biofilms – is THE all around miracle tonic.

  2. Hi Mikko,

    Thanks for sharing that list of biofilm busters! Good info to have on this post about biofilms.
    What brand of Tulsi do you use?
    I am a strong believer of natural supplements. I use Neem – not sure if it a biofilm buster or not, but it is a strong detoxifier and supports the immune system.

  3. Pingback: Antibiotics for Prostatitis: Why They Don’t Work – Beating Prostatitis

  4. Kevin Kennedy

    Hi Pranav,I have been suffering with what was diagnosed ae (Acute Prostatis) since June 1st. The symptoms started in early May 2018,The Urologist gave me Bactrim 6 weeks..It seemed to help but now its back..He seems to think its my “Imagination” since my Flow test was good..STD test was neg.Ultrasound of scrotal area showed Bilateral Hydraceles and I had a Vericocele that I had Embolized..but The symtoms are pretty bad..Urgent need to urinate..often at night..and the Drip when done..pressure in scrotal Abdomen area.Depression..I suggested a Semen check but the Urologist said I have a “clean bill of health” We checked PSA (On My Request) it was 2.33 which is good..but this haunts me..What should be my next step?? Thanks for thi Blob..and any advice .Kevin

    1. Pranav

      Hey Kevin,

      Acute prostatitis often tends to linger on as chronic prostatitis. I suggest you try to find a urologist who will agree to do a prostate fluid test for you. Semen culture would be a second best option…you dont need a urologist for that. Just give the sample directly at a good lab. PSA is not really the appropriate test for correctly diagnosing prostatitis. Check out this post where I have spoken about the tests to correctly diagnose prostatitis:

      1. Kevin

        Thanks so much Pranav,I will try to do exactly what you have suggested, Talk with you very soon, Best regards to you

    1. Pranav

      Hi Kevin, I know of a few people who have tried Fosfomycin over a long term for their prostatitis. In most cases, symptoms got suppressed while taking the antibiotics, but after finishing the course the symptoms came back gradually. The reason seems to be that the antibiotic did not actually break the biofilms, it only killed the planktonic bacteria. Since the biofilms remained unaffected, the infection reappeared once the antibiotic dosage was stopped.

  5. Kevin

    Thank you Pranav, for your information, I will not pursue this antibiotic, I have an appointment with another urologist (My 3rd,) and I am hoping he will help me with the proper detection (Prostate fluid test) to check for infection. Much appreciation.

    1. Hey Kevin, I diagnosed my epididymitis using 3 tests. First was a semen analysis, that showed an elevated WBC count indicating an infection. Second was a semen culture, that showed a growth of enterococcus faecalis. Third was an ultrasound of the scrotum (called scrotal doppler) which showed an inflammation of the right epididymis. The ultrasound revealed the inflammation, the lab tests revealed the infection, and thats how my epididymitis was properly diagnosed.

  6. Steve

    We as patients should not have to become cellular biologists in an attempt to cure us of this hell called prostate pain, inflammation etc. All we are doing is making these urologists wealthy. I took cipro for a month and then for an additional 10 days before my prostate biopsy and cystoscope with biopsy. Two days later I had to go to the ER with a raging UTI and guess what. The prostate biopsy gives you prostate inflammation all over again. And, and when you encounter female pa’s etc at the ER of course they don’t have a prostate and when you tell them what test you had ” prostate biopsy and cysto biopsy” they look at you as if ” what’s that?”

    1. Pranav

      I hope you are feeling better now, Steve. Thanks for raising this important point. Many urologists prescribe a cystoscopy for their prostatitis patients, despite this procedure having very little use in diagnosing or treating this condition. In my opinion, cystoscopy is useful only if there is a bladder neck obstruction which is severely affecting urinary flow. I have come across many prostatitis sufferers for whom the symptoms of the condition worsened after getting a cystoscopy.

      Prostate biopsy is commonly done trans-rectally, and puncturing the rectal wall creates a new path for bacteria to invade and infect the prostate. This should only be done if the urologist has strong reason to suspect prostate cancer.

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