The cause of infectious cystitis is the action of pathogenic microorganisms, which, as a result of their vital activity, cause an inflammatory process.Pathogens can come from outside or be conditional: they remain in an inactive phase in the genitourinary system and are activated under the influence of adverse factors and a decrease in immune protection.
The disease has gender characteristics: cystitis most often occurs in women aged 25-40 due to the anatomical and physiological characteristics of the genitourinary system.However, cystitis can occur at any age in adults and children.
It is difficult to ignore the symptoms of inflammation of the bladder mucosa: the first sign is usually pain in the lower abdomen, burning, itching, frequent urges and pain when urinating.An increase in temperature is also possible: cystitis can give any signs of general inflammation.
The provoking factor for the development of the disease is usually hypothermia and then a decrease in the body's defenses.Cystitis can also be provoked by changes in sexual activity and other reasons for disrupting the normal vaginal microflora.
Cystitis in women: treatment
The difficulty of treatment is that cystitis is often not considered a serious disease, while its complications can disrupt the functioning of the genitourinary system.Prescribing antimicrobial drugs is the only type of treatment that directly affects the cause of the inflammation.Self-medication in this case is unacceptable: there is a high risk of taking ineffective drugs and, as a result, the transition of acute inflammation into a chronic form with constant exacerbations or sudden development of complications.It should be remembered that the complications of cystitis in women and men lead to pyelonephritis, glomerulonephritis, sphincter dysfunction with constant uncontrolled urination.
The treatment of cystitis should be comprehensive: take into account the characteristics of the clinical picture, the results of research, the medical history and the reaction to drugs.However, the mainstay of the treatment regimen for both women and men always remains a natural or synthetic antimicrobial drug.
Antimicrobial drugs for cystitis
The effect of drugs in the fight against microorganisms is selective inhibition or termination of their vital functions.Depending on the nature of the pathogen, antibacterial, antifungal (antimycotic) and antiprotozoal drugs are prescribed.Viral origin of cystitis is rare.It is quickly complicated by the addition of a bacterial infection, so in any case the disease requires the prescription of antibiotics.
A group of drugs that are effective in treating inflammatory processes in the genitourinary system are called uroseptics.Antiseptics, synthetic antimicrobials and antibiotics from the category of uroseptics are excreted through the kidneys.This creates an effective therapeutic concentration of the drug at the site of inflammation during cystitis.
Classification of uroseptics
Accent:
- Herbal remedies for cystitis.
- Antibiotics of natural origin (penicillins, cephalosporins of the first and third generation, tetracyclines, glycopeptides).
- Synthetic drugs with antimicrobial activity (quinolone derivatives, fluoroquinolones, sulfonamides, 9-hydroxyquinoline derivatives, nitrofuran derivatives).
- Other antibiotics (trimethoprim), combined antimicrobial drugs.
- Antifungal drugs.
Herbal uroseptics
St. John's wort herb + sedum root + rosemary leaves - this is a composition of a preparation from the group of phytotherapeutic agents, which has proven its clinical effectiveness in practice.A universal medicine based on rosemary, centaury and hunter is available in two forms: an alcoholic solution with a drop dose and capsules.The combination of herbal components provides anti-inflammatory, antispasmodic and antiseptic action.For pregnant women, it is better to use tablets.
Another popular herbal remedy for cystitis is tablets containing:
- purified mummy powder,
- flower extract of St.
- saxifrage stem extract,
- madder stem extract,
- rhizome extract of Sati membranous,
- straw seed extract,
- extract of the aerial part of Onosma bracts,
- vernonia ashen whole plant extract,
- lime silicate powder.
The drug has antimicrobial, antispasmodic, anti-inflammatory, analgesic and diuretic effects in cystitis.
antibiotics
A group of naturally occurring antibiotics were widely used before the era of antibiotic resistance.With the enormous resistance of bacteria to antibacterial agents, it is necessary to search for new synthetic analogues of antibiotics with an extended spectrum of action and a low risk of developing resistance.
But some cases of cystitis require the prescription of drugs from the group of antibacterial agents of natural origin.Broad-spectrum antibiotics of the latest generations are used, which are effective against most typical causes of cystitis.It is especially important to prescribe a drug with a broad spectrum of antimicrobial activity at the stage until the exact name of the microbial agent - the causative agent of inflammatory bladder disease - is identified.
Penicillins
Penicillin derivatives block the enzyme system that serves as the basis for the formation of the cell wall.Medicines have a bactericidal effect.To improve effectiveness, penicillin drugs are combined with clavulanic acid.It inhibits the beta-lactamase system, further promoting the destruction of the cell wall of microorganisms.In urology, such semi-synthetic representatives of the group "protected" by clavulanic acid are used.They can be prescribed to pregnant women if the risk of infection outweighs the risk of toxicity to the fetus.
Cephalosporins
The group is characterized by the prescription of drugs mainly not in tablets, but in injectable forms, which ensures rapid achievement of the effect.Antibiotics damage the cell wall of pathogens.Severe and complicated cases of cystitis are treated with cephalosporins in the form of intramuscular injections.Cefotaxime, ceftriaxone, cefoperazone (III generation drugs with a wide spectrum of antibacterial activity) are prescribed.Uncomplicated forms of cystitis in women and men can be treated without injections: tablets of third-generation cephalosporin antibiotics are prescribed - cefixime, ceftibuten.
Phosphonic acid derivatives
Fosfomycin is a broad-spectrum antibiotic that has proven effective against cystitis pathogens in clinical trials and in practice.The active substance in the tablet is fosfomycin trometamol.Its molecule inhibits the first step in the formation of the microbial cell wall.Due to the high concentration of the drug in the urine, which is maintained for 24-48 hours, the drug can be successfully used in the treatment of cystitis.
important!When choosing an antibiotic, you should focus on the concentration of active components in urine.Then a bactericidal level of the antimicrobial substance in the urine is achieved.It is also important that the drug for cystitis in women has little effect on the vaginal microflora, as this creates an additional risk of progression or recurrence of cystitis.
Combinations of antibiotics are effective in cystitis (trimethoprim in combination with sulfamethoxazole) even fights against rare pathogenic microorganisms (S. saprophyticus).It is important to observe the regimen and duration of antibiotic therapy.The duration of treatment can be from 3 to 14 days or even more, depending on the complexity and severity of the case.
Synthetic uroseptics
All synthetic agents that act on pathogenic microorganisms have good antimicrobial activity.However, for the treatment of cystitis, representatives of synthetic uroseptics are most often used - drugs that ensure the maximum concentration of the active substance in the organs of the genitourinary system.
Fluoroquinolones
Fluoroquinolones are the latest generation of quinolones that inhibit microbial enzymes (DNA gyrase), providing a bactericidal effect in cystitis.Medicines have a wide spectrum of action, affecting even microbes with pronounced resistance to other antibacterial agents.
High bioavailability, low probability of side effects and good tolerability are the reasons for the frequent prescription of this group of antibiotics for cystitis.
Ciprofloxacin is the most popular uroseptic tablet from the group of fluoroquinolones.Its clinical effects are well studied.You can find such trade names of the active substance.
Norfloxacin and Levofloxacin are also used to treat cystitis.
Nitrofuran derivatives
In urological practice, the drug "Furagin", an antibiotic with a wide spectrum of antimicrobial activity, is widely used.The level of the drug in the urine is several times higher than the minimum bacteriostatic concentration for pathogenic microbes in the treatment of cystitis.
Nitrofurantoin is the second known representative of the group.The active ingredient is nitrofurantoin.It is quickly excreted in the urine, the action in the genitourinary system begins 2-4 hours after taking furadonin, and the proportion of the unchanged drug in the urine is about 45%.This provides a good effect in the treatment of uncomplicated cystitis in men and women caused by aerobic gram-positive or gram-negative microflora.
Sulfonamides and their combinations
This group of synthetic antibiotics were the first chemical alternatives to natural antibiotics.For some time, representatives of the sulfonamide series remained in reserve due to the prescription of other groups of drugs.Therefore, now the causative agents of infectious cystitis are susceptible to the action of sulfonamides, and the drugs have a good effect.
Combinations of drugs are also often prescribed.Thanks to this, a better treatment effect can be achieved.A well-known representative of the group of combined drugs, which includes sulfamethoxazole and trimethoprim.
Sulfamethoxazole is similar in chemical structure to para-aminobenzoic acid (PABA), which allows the drug to participate in the synthesis of important structural elements of microbial cells.Trimethoprim enhances the effect of sulfamethoxazole by interfering with the production of folic acid.This significantly disrupts the metabolism in bacterial cells and leads to their death.
The drug has a wide range of action and also creates the necessary level of active components in urine to fight infections of the genitourinary system.The course of treatment for uncomplicated cystitis is 6 days.Strict adherence to the duration of antibiotic therapy is important for successful recovery and prevention of re-infection.
Antifungal (antimycotic) drugs
Medicines are prescribed if the fungal nature of cystitis is confirmed or to prevent fungal infections during antibiotic treatment.Candidiasis is one of the frequent complications of antibacterial therapy.To prevent it or successfully treat it, you need to prescribe an antifungal.
Medicines such as fluconazole, ketoconazole and itraconazole are used for cystitis.
Features of the choice and use of uroseptic
The patient must remember that the medicine must be taken strictly according to the doctor's prescription: you cannot stop the treatment or change the medicine yourself.Also, to prevent the resistance of microorganisms to the drug, the uroseptic should be changed as prescribed by the doctor during long-term treatment.
The resistance of the microbes in cystitis develops slowly to drugs from the groups of ampicillin, fluoroquinolones, chloramphenicol and furagin.The rapid development of resistance to tetracyclines, streptomycin and cephalosporins led to the fact that representatives of this series are practically not used for the treatment of cystitis in modern clinical practice.
Doctors often prescribe combination drugs or several drugs at the same time.Combinations of furagin with chloramphenicol or sulfonamides, as well as combinations of sulfanilamide with chloramphenicol, expand the spectrum of action of compound drugs for cystitis and increase the effectiveness of therapy.
Herbal uroseptics combine safely and effectively with all known chemicals.They can be used for the development of cystitis in women during pregnancy.
The doctor, urologist or nephrologist is often faced with the task of choosing the optimal uroseptic for the treatment of a specific case of cystitis.The doctor must determine the localization of the infectious process and, if possible, find out the type of pathogen and its sensitivity to known uroseptics.Also, during the examination, it is important to establish the phase of inflammation and make sure that there are no complications from the kidneys.When diagnosing inflammation of the bladder in women, the doctor must make sure that there is no pregnancy, because the drugs can be toxic to the unborn child.
Only after the specialist receives answers to all questions, he can choose an effective and safe medicine - injections or tablets.Self-prescribing drugs with uroseptic activity in cystitis can lead to unwanted complications, weak effect and development of resistance of microorganisms.