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 unfavorable factors and a decrease in immune defense.
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 also occur at any age in adults and children.
It is difficult to ignore the symptoms of inflammation of the lining of the urinary bladder: the first sign is usually pain in the lower abdomen, burning, itching, frequent urge and pain during urination.An increase in temperature is also possible: cystitis can give any signs of general inflammation.
The driving factor in the development of the disease is usually hypothermia, and then the reduction of the body's defenses.Cystitis can also be caused by changes in sexual activity and other causes of disruption of 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 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 worsening or sudden development of complications.It should be remembered that complications of cystitis in women and men lead to pyelonephritis, glomerulonephritis, sphincter dysfunction with constant uncontrolled urination.
The treatment of cystitis should be comprehensive: the characteristics of the clinical picture, test results, medical history and reaction to drugs are taken into account.However, the basis of the treatment regimen for both women and men always remains a natural or synthetic antimicrobial.
Antimicrobial drugs for cystitis
The effect of drugs in the fight against microorganisms is to selectively inhibit or interrupt 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 prescription of antibiotics is necessary.
A group of drugs that are effective in the treatment of inflammatory processes in the genitourinary system are called "uroseptics".Antiseptics, synthetic antimicrobial agents 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
Highlight:
- Herbal remedies for the treatment of 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
Centaury grass + Lovage root + Rosemary leaves - this is the composition of the drug from the group of phytotherapeutic agents, which has proven its clinical effectiveness in practice.The universal medicine based on rosemary, centaury and lovage is available in two forms: an alcohol solution with a dose in drops and capsules.The combination of herbal components provides anti-inflammatory, antispasmodic and antiseptic effects.For pregnant women, it is better to use tablets.
Another popular herbal remedy for cystitis is pills that contain:
- purified mummy powder,
- flower extract of St.
- saxifrage stem extract,
- beech stem extract,
- Sati membrane rhizome extract,
- straw seed extract,
- extract of the aerial part of Onosma leaves,
- vernonia ash whole plant extract,
- lime silicate powder.
The drug has antimicrobial, antispasmodic, anti-inflammatory, analgesic and diuretic effects in cystitis.
Antibiotics
A group of natural antibiotics were widely used before the era of antibiotic resistance.With the high resistance of bacteria to antibacterial agents, there is a need to search for new synthetic analogues of antibiotics with an extended spectrum of action and a low risk of developing resistance.
However, 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 of the typical causes of cystitis.It is especially important to prescribe a drug with a broad spectrum of antimicrobial action in the phase until the exact name of the microbial agent - the causative agent of inflammatory bladder disease - has been determined.
Penicillins
Penicillin derivatives block the enzyme system, which serves as the basis for the formation of the cell wall.Medicines have a bactericidal effect.To increase effectiveness, penicillin drugs are combined with clavulanic acid.It inhibits the beta-lactamase system, further encouraging the destruction of the cell wall of microorganisms.Such semi-synthetic representatives of the group "protected" by clavulanic acid are used in urology.They can be prescribed to pregnant women if the risk of infection is greater than the risk of toxicity to the fetus.
Cephalosporins
The group is characterized by prescribing drugs mostly not in tablets, but in the form of injections, which ensures a quick 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 (3rd generation drugs with a wide spectrum of antibacterial action) 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 been shown to be effective against cystitis pathogens in clinical studies and in practice.The active substance in the tablet is fosfomycin trometamol.Its molecule inhibits the first phase of the formation of microbial cell walls.Due to the high concentration of the drug in 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 need to focus on the concentration of active components in the urine.Then the bactericidal level of the antimicrobial substance in the urine is achieved.It is also important that the drug for cystitis in women has a weak effect on the vaginal microflora, because this creates an additional risk for the progression or recurrence of cystitis.
Antibiotic combinations are effective in cystitis (trimethoprim in combination with sulfamethoxazole) even against rare pathogenic microorganisms (S. saprophyticus).It is important to adhere to 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, acting even on 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 in the group of fluoroquinolones.Its clinical effects have been 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 another well-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 gives 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 was the first of the chemical alternatives to natural antibiotics.For some time, representatives of the sulfonamide series remained in reserve due to the prescription of other drug groups.Therefore, now the causative agents of infectious cystitis are sensitive to the action of sulfonamides, and the drugs have a good effect.
Combinations of drugs are often prescribed.Thanks to this, a better treatment effect can be achieved.A well-known representative of the group of combined drugs that includes sulfamethoxazole and trimethoprim.
Sulfamethoxazole is chemically similar to para-aminobenzoic acid (PABA), which allows the drug to be involved 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 spectrum of action and also creates the necessary level of active components in the urine to fight infections of the genitourinary system.The course of treatment for uncomplicated cystitis is 6 days.It is important to strictly adhere to the duration of antibiotic therapy for successful recovery and prevention of recurrence of 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.In order to prevent it or successfully treat it, it is necessary to prescribe an antimycotic.
Medicines such as fluconazole, ketoconazole and itraconazole are used for cystitis.
Features of the selection and use of uroseptics
The patient must remember that the drug should be taken strictly as prescribed by the doctor: you cannot stop the treatment or change the drugs yourself.Also, in order to prevent the resistance of microorganisms to the drug, the uroseptic must be changed as prescribed by the doctor during long-term treatment.
Microbial resistance 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 has 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 combined 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 the component drugs for cystitis and increase the effectiveness of therapy.
Herbal uroseptics are safely and effectively combined with all known chemicals.They can be used for the development of cystitis in women during pregnancy.
A 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 should determine the localization of the infectious process and, if possible, determine the type of pathogen and its sensitivity to known uroseptics.Also during the examination, it is important to determine the stage of inflammation and make sure that there are no complications on the kidneys.When diagnosing inflammation of the urinary bladder in women, the doctor should make sure that there is no pregnancy, because the drugs can be toxic to the unborn child.
Only after the specialist gets answers to all questions, can he choose an effective and safe drug - injections or tablets.Self-prescription of drugs with uroseptic action for cystitis can lead to unwanted complications, weak action and the development of resistance of microorganisms.