The cause of infectious cystitis is the effect of pathogenic microorganisms, which cause an inflammatory process as a result of their vital activity.Pathogens can come from outside or be conditional: they remain in an inactive phase in the urogenital system and are activated under the influence of unfavorable 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 urogenital system.However, cystitis can appear in adults and children at any age.
Symptoms of inflammation of the bladder mucosa are difficult to ignore: the first symptom is usually lower abdominal pain, burning sensation, itching, frequent desire and pain during urination.An increase in temperature is also possible: cystitis can indicate any general inflammation.
The triggering factor for the development of the disease is usually hypothermia, followed by a decrease in the body's defenses.Cystitis can also be triggered by changes in sexual activity and other reasons that disrupt the normal vaginal microflora.
Cystitis in women: treatment
The difficulty in treatment is that cystitis is often not considered a serious disease, while its complications can disrupt the functioning of the urinary system.Prescribing antimicrobial drugs is the only 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 exacerbations or the sudden development of complications.It should be remembered that the complications of cystitis in women and men lead to pyelonephritis, glomerulonephritis, dysfunction of the sphincter muscle with constant uncontrolled urination.
The treatment of cystitis should be comprehensive: it is necessary to take into account the characteristics of the clinical picture, test results, medical history and reactions to drugs.However, the basis of the regimen for women and men always remains a natural or synthetic antimicrobial drug.
Antimicrobial agents for the treatment of cystitis
The effect of drugs in the fight against microorganisms is to selectively inhibit or stop 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 bacterial infection, which is why the disease requires a prescription of antibiotics in all cases.
The group of drugs effective in the treatment of inflammatory processes of the urogenital system is called "uroseptic".Antiseptics, synthetic antimicrobials and antibiotics belonging to the uroseptic category 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 medicines for the treatment of cystitis.
- Antibiotics of natural origin (penicillins, first and third generation cephalosporins, tetracyclines, glycopeptides).
- Antimicrobial synthetic drugs (quinolone derivatives, fluoroquinolones, sulfonamides, 9-hydroxyquinoline derivatives, nitrofuran derivatives).
- Other antibiotics (trimethoprim), combined antimicrobials.
- Antifungals.
Plant uroseptics
Centaury herb + Lovage root + rosemary leaves - this is the composition of a medicine belonging to the group of phytotherapeutic agents, which has proven its clinical effectiveness in practice.The universal remedy based on rosemary, centaury and lovage is available in two forms: alcoholic solution with drop dosage and capsules.The combination of plant ingredients provides an anti-inflammatory, antispasmodic and antiseptic effect.It is better to use tablets for pregnant women.
Another popular remedy for the treatment of cystitis with herbs is pills that contain:
- purified mumiyo powder,
- St. Stephen's flower extract.
- saxifrage stem extract,
- madder stem extract,
- Sati membranous rhizome extract,
- straw flower extract,
- extract of the aerial part of Onosma bracts,
- vernonia ash whole plant extract,
- silicate powder.
The drug has antimicrobial, antispasmodic, anti-inflammatory, analgesic and diuretic effects for cystitis.
Antibiotics
A group of naturally occurring antibiotics were widely used before the era of antibiotic resistance.Due to the massive resistance of bacteria to antibacterial agents, it is necessary to search for new synthetic analogues of antibiotics, which have an extended spectrum of action and a low risk of developing resistance.
However, some cases of cystitis require the prescription of drugs belonging to the group of antibacterial agents of natural origin.The latest generations use broad-spectrum antibiotics that are effective against the most typical pathogens of cystitis.It is especially important to prescribe a broad-spectrum antimicrobial drug at the stage until the exact name of the microbial agent - the causative agent of the inflammatory disease of the bladder - has been determined.
Penicillins
Penicillin derivatives block the enzyme system that serves as the basis for the formation of the cell wall.The drugs have a bactericidal effect.To increase effectiveness, penicillin drugs are combined with clavulanic acid.It inhibits the beta-lactamase system, further helping 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 exceeds the risk of toxicity to the fetus.
Cephalosporins
This group is characterized by the fact that the drugs are mainly prescribed not in tablets, but in injection form, which ensures that the effect is achieved quickly.Antibiotics damage the cell wall of pathogens.Severe and complicated cases of cystitis are treated with cephalosporins in the form of intramuscular injection.Cefotaxime, Ceftriaxone, Cefoperazone (III generation drugs with broad-spectrum antibacterial activity) are prescribed.Uncomplicated forms of cystitis in women and men can be treated without injections: tablets of third-generation cephalosporin antibiotics - cefixime, ceftibuten - are prescribed.
Phosphonic acid derivatives
Fosfomycin is a broad-spectrum antibiotic that has been shown to be effective against cystitis pathogens in clinical trials and in practice.The active ingredient of the tablet is fosfomycin-trometamol.Its molecule inhibits the first stage of microbial cell wall formation.Due to the high concentration of the drug in the urine, which remains 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 the urine.Bactericidal levels of the antimicrobial substance are then achieved in the urine.It is also important that the medicine used to treat cystitis in women has little effect on the microflora of the vagina, as this poses an additional risk for the progression or recurrence of cystitis.
Combinations of antibiotics are effective in cystitis (trimethoprim combined with sulfamethoxazole), even against rare pathogenic microorganisms (S. saprophyticus).It is important to follow the schedule and duration of antibiotic therapy.The duration of treatment can be 3-14 days or even more depending on the complexity and severity of the case.
Synthetic uroseptics
All synthetic agents that act on pathogenic microorganisms have a good antimicrobial effect.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 urogenital system.
Fluoroquinolones
Fluoroquinolones are the latest generation of quinolones that inhibit microbial enzymes (DNA gyrase) and have a bactericidal effect in cystitis.The drugs have a broad spectrum of action, they even affect microbes with pronounced resistance to other antibacterial agents.
High bioavailability, low probability of side effects and good tolerability are the reasons why this group of antibiotics is often prescribed for the treatment of cystitis.
Ciprofloxacin is the most popular uroseptic pill in the group of fluoroquinolones.Its clinical effects have been extensively studied.You can find such trade names for the active ingredient.
Norfloxacin and levofloxacin are also used to treat cystitis.
Nitrofuran derivatives
In urological practice, the drug "Furagin" is widely used, an antibiotic with a broad spectrum of antimicrobial action.The level of the drug in the urine is several times the minimum bacteriostatic concentration of pathogenic microbes in the treatment of cystitis.
Nitrofurantoin is the second well-known representative of the group.The active ingredient is nitrofurantoin.It is quickly excreted in the urine, the effect in the urogenital 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 caused by aerobic gram-positive or gram-negative microflora in men and women.
Sulfonamides and their combinations
This class of synthetic antibiotics was the first chemical alternative to naturally occurring antibiotics.For some time, representatives of the sulfonamide series remained in reserve due to the prescription of other drug groups.Therefore, now the pathogens 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 effect can be achieved in the treatment.It is a well-known representative of the group of combined drugs containing sulfamethoxazole and trimethoprim.
The chemical structure of sulfamethoxazole is similar to para-aminobenzoic acid (PABA), which allows the drug to participate in the synthesis of important structural elements of microbial cells.Trimethoprim increases the effect of sulfamethoxazole by interfering with the production of folic acid.This significantly disrupts the metabolism in the bacterial cells and leads to their death.
The drug has a wide spectrum of action and creates the necessary amount of active components in the urine to fight infections of the urogenital system.The duration of treatment for uncomplicated cystitis is 6 days.In order to achieve a successful recovery and to prevent the recurrence of the infection, it is important to strictly adhere to the duration of antibiotic therapy.
Antifungal (antifungal) medications
Medicines are prescribed when the fungal nature of cystitis is confirmed, or to prevent fungal infections during antibiotic treatment.Candidiasis is a common complication of antibacterial therapy.You will need to prescribe an antifungal medication to prevent or successfully treat it.
Medicines such as fluconazole, ketoconazole and itraconazole are used to treat cystitis.
Features of the selection and use of uroseptic
The patient must remember that the medicine must be taken strictly as prescribed by the doctor: he cannot stop the treatment or change the medicine on his own.In addition, in order to prevent the resistance of microorganisms to the drug, uroseptic should be changed as prescribed by the doctor during long-term treatment.
In cystitis, the resistance of microbes slowly develops against drugs belonging to the group of ampicillins, 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 combination drugs or several drugs at the same time.Furagin with chloramphenicol or sulfonamides, as well as combinations of sulfanilamide and chloramphenicol, expand the spectrum of action of cystitis components and increase the effectiveness of therapy.
Herbal uroseptics are safely and effectively combined with all known chemicals.They can be used to treat 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 must determine the localization of the infectious process and, if possible, find out the type of pathogen and its sensitivity to known uroseptics.During the examination, it is also important to determine the stage of the inflammation and make sure that there are no kidney complications.When diagnosing cystitis in women, the doctor must make sure that there is no pregnancy, since the drugs can be toxic to the unborn child.
Only after the specialist receives answers to all questions, you can choose an effective and safe medicine - injections or tablets.Self-prescribing drugs with uroseptic activity for cystitis can lead to unwanted complications, weak effect and the development of resistance of microorganisms.