The cause of infectious cystitis is the action of pathogenic microorganisms, which, due to their vital activity, trigger an inflammatory process.Pathogens can come from outside or be conditional: they remain in the genitourinary system in an inactive phase and are activated under the influence of unfavorable factors and a decrease in immune defense.
The disease has sexual characteristics: due to the anatomical and physiological characteristics of the genitourinary system, cystitis occurs most often in women aged 25-40 years.However, cystitis can also occur in adults and children of any age.
The symptoms of bladder inflammation are difficult to ignore: The first signs are usually pain in the lower abdomen, burning, itching, frequent urge to urinate and pain when urinating.An increase in temperature is also possible: a bladder infection can cause signs of general inflammation.
The triggering factor in the development of the disease is usually hypothermia and a subsequent decrease in 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 affect the functioning of the genitourinary system.Prescribing antimicrobial medications is the only type of treatment that directly targets 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 the sudden development of complications.It should be remembered that complications of cystitis in women and men lead to pyelonephritis, glomerulonephritis and sphincter disorders with constant uncontrolled urination.
Treatment of cystitis should be comprehensive: the features of the clinical picture, test results, medical history and reactions to medications are taken into account.However, the basis of the treatment regimen for 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 to specifically inhibit or terminate their vital functions.Depending on the type of pathogen, antibacterial, antifungal (antifungal) and antiprotozoal drugs are prescribed.A viral cause of cystitis is rare.With the addition of a bacterial infection, things quickly become complicated, so the disease always requires the prescription of antibiotics.
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 uroseptic category are excreted through the kidneys.This creates an effective therapeutic concentration of the drug at the site of inflammation in cystitis.
Classification of uroseptics
Highlight:
- Herbal medicines for the treatment of bladder infections.
- Antibiotics of natural origin (penicillins, first and third generation cephalosporins, tetracyclines, glycopeptides).
- Synthetic drugs with antimicrobial effects (quinolone derivatives, fluoroquinolones, sulfonamides, 9-hydroxyquinoline derivatives, nitrofuran derivatives).
- Other antibiotics (trimethoprim), antimicrobial combination preparations.
- Antifungal medications.
Herbal uroseptics
Centaury + lovage root + rosemary leaves - this is a composition of a drug from the group of phytotherapeutics, which has proven to be clinically effective in practice.A panacea based on rosemary, centaury and lovage is available in two forms: as an alcohol solution with drop dosage and as 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 medicine for cystitis is tablets containing:
- purified mumiyo powder,
- Extract from flowers of St.
- Saxifrage stem extract,
- madder stem extract,
- Extract from rhizomes of Sati membranous,
- Strawflower seed extract,
- Extract from the aerial part of the Onosma bracts,
- Vernonia ash whole plant extract,
- Lime silicate powder.
The drug has antimicrobial, antispasmodic, anti-inflammatory, analgesic and diuretic properties for cystitis.
Antibiotics
A group of naturally occurring antibiotics were widely used before the era of antibiotic resistance.Given the massive resistance of bacteria to antibacterial agents, there is a need to search for new synthetic analogues of antibiotics with an expanded spectrum of action and a low risk of resistance development.
However, in some cases of cystitis, the prescription of drugs from the group of antibacterial agents of natural origin is necessary.The latest generation of broad-spectrum antibiotics are used, which are effective against most of the typical pathogens that cause cystitis.It is especially important to prescribe a drug with a broad spectrum of antimicrobial activity until the exact name of the microbial pathogen - the causative agent of the inflammatory disease of the bladder - 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 increase effectiveness, penicillin drugs are combined with clavulanic acid.It inhibits the beta-lactamase system and thus promotes the destruction of the cell wall of microorganisms.Such semi-synthetic representatives of the group “protected” by clavulanic acid are used in urology.They may 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 fact that drugs are predominantly prescribed not in tablet form, but in injectable 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 injections.Cefotaxime, ceftriaxone, cefoperazone (third 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 with third-generation cephalosporin antibiotics - cefixime, ceftibuten - are prescribed.
Phosphonic acid derivatives
Fosfomycin is a broad-spectrum antibiotic that has proven effective against cystitis pathogens in clinical trials and practice.The active ingredient in 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 lasts 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 substances in the urine.A bactericidal level of the antimicrobial substance in the urine is then 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 for cystitis (trimethoprim in combination with sulfamethoxazole) and even fight rare pathogenic microorganisms (S. saprophyticus).It is important to adhere to the regimen and duration of antibiotic therapy.The duration of treatment can be 3 to 14 days or more, depending on the complexity and severity of the case.
Synthetic uroseptics
All synthetic active ingredients 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 provide the maximum concentration of the active ingredient in the organs of the urogenital system.
Fluoroquinolones
Fluoroquinolones are the latest generation of quinolones that inhibit microbial enzymes (DNA gyrase) and thus have a bactericidal effect on bladder infections.Drugs have a wide spectrum of action and also affect microbes that have 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 bladder infections.
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 ingredient.
Norfloxacin and levofloxacin are also used to treat bladder infections.
Nitrofuran derivatives
In urological practice, the drug “Furagin”, an antibiotic with a broad spectrum of antimicrobial action, is often used.The drug level in 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 effect in the genitourinary system begins 2-4 hours after taking furadonin, and the proportion of 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 was the first chemical alternative to naturally occurring antibiotics.Due to the prescription of other groups of drugs, representatives of the sulfonamide series remained in reserve for some time.Therefore, the causative agents of infectious cystitis are now susceptible to the effects of sulfonamides and the drugs have a good effect.
Combinations of medications are often prescribed.This can achieve a better treatment effect.A well-known representative of the group of combination 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 increases the effects 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 ensures the necessary amount of active ingredients in the urine to combat infections of the urogenital system.The duration of treatment for uncomplicated cystitis is 6 days.For a successful recovery and prevention of recurrence of the infection, it is important to strictly adhere to the duration of antibiotic therapy.
Antifungal (antifungal) drugs
Medication is prescribed if the fungal nature of cystitis is confirmed or to prevent fungal infections during treatment with antibiotics.Candidiasis is one of the most common complications of antibiotic therapy.To prevent or successfully treat this, you must prescribe an antifungal medication.
For cystitis, drugs such as fluconazole, ketoconazole and itraconazole are used.
Features of the selection and use of uroseptics
The patient must remember that the drug should be taken strictly according to the doctor's prescription: you cannot stop treatment or change medications on your own.In order to prevent resistance of microorganisms to the drug, the uroseptic must be changed as prescribed by a doctor during long-term treatment.
The resistance of microbes in cystitis develops slowly to drugs from the groups 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 to treat cystitis in modern clinical practice.
Doctors often prescribe combination medications or several medications 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 active ingredients against cystitis 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 selecting the optimal uroseptic for the treatment of a specific cystitis.The doctor must determine the location 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 inflammatory phase and to ensure that there are no complications from the kidneys.When diagnosing cystitis in women, the doctor must make sure that there is no pregnancy, as medications can be toxic to the unborn child.
Only after the specialist receives answers to all questions can he choose an effective and safe drug - injections or tablets.Self-prescription of drugs with uroseptic effect for cystitis can lead to undesirable complications, weak effect and development of resistance in microorganisms.