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 the 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 years due to the anatomical and physiological characteristics of the genitourinary system.However, cystitis can also appear 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 urge and pain when urinating.An increase in temperature is also possible: cystitis can give any signs of general inflammation.
The triggering factor in 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 causes of disruption of the normal vaginal microflora.
Cystitis in women: treatment
The difficulty of treatment is that cystitis is often not regarded as 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 medications 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, dysfunction of the sphincters with constant uncontrolled urination.
Treatment of cystitis should be comprehensive: the features 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 drug.
Antimicrobial drugs for cystitis
The effect of drugs in the fight against microorganisms is to selectively inhibit or terminate 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 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 during cystitis.
Classification of uroseptics
Highlight:
- Herbal medicines for the treatment of cystitis.
- Antibiotics of natural origin (penicillins, cephalosporins of the first and third generations, tetracyclines, glycopeptides).
- Synthetic drugs with antimicrobial activity (quinolone derivatives, fluoroquinolones, sulfonamides, 9-hydroxyquinoline derivatives, nitrofuran derivatives).
- Other antibiotics (trimethoprim), combination antimicrobial drugs.
- Antifungal drugs.
Plant uroseptics
Centaury herb + Lovage root + Rosemary leaves - this is a composition of a drug from the group of phytotherapeutic agents, which has proven its clinical effectiveness in practice.A universal remedy based on rosemary, centaury and lovage is available in two forms: an alcohol solution with a drop dosage 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 medicine for herbal medicine for cystitis is tablets containing:
- purified mumiyo powder,
- extract of flowers of St.
- saxifrage stem extract,
- madder stem extract,
- extract of rhizomes of Sati membranous,
- strawflower seed extract,
- extract of the aerial part of Onosma bracts,
- vernonia ashy whole plant extract,
- lime 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.With 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 activity 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 typical pathogens of cystitis.It is especially important to prescribe a drug with a wide range of antimicrobial activity at the stage until the exact name of the microbial agent - the causative agent of inflammatory disease of the bladder - has been identified.
Penicillins
Penicillin derivatives block the enzymatic system, which serves as the basis for the formation of the cell wall.Medicines have a bactericidal effect.To enhance 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 may be prescribed for 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 - cefixime, ceftibuten - are prescribed.
Phosphonic acid derivatives
Fosfomycin is a broad-spectrum antibiotic that has proven effective against cystitis pathogens in clinical studies and in practice.The active substance 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 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 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, since this creates an additional risk for the progression or reappearance of cystitis.
Combinations of antibiotics are effective for cystitis (trimethoprim in combination with sulfamethoxazole) even fights rare pathogenic microorganisms (S. saprophyticus).It is important to comply with 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 provide 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 likelihood 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 fluoroquinolone group.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” is widely used, an antibiotic with a wide spectrum of antimicrobial activity.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 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 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
These group of synthetic antibiotics were the first of the chemical alternatives to naturally occurring 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 medications are also often prescribed.Thanks to this, a better effect in treatment can be achieved.A well-known representative of the group of combination drugs that includes sulfamethoxazole and trimethoprim.
Sulfamethoxazole is similar in chemical structure 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 combat 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) medications
Drugs are prescribed if the fungal nature of cystitis is confirmed or to prevent fungal infections during treatment with antibiotics.Candidiasis is one of the common complications of antibacterial therapy.To prevent it or successfully treat it, you need to prescribe an antimycotic.
For cystitis, medications such as fluconazole, ketoconazole, and itraconazole are used.
Features of the selection and use of uroseptic
The patient must remember that the drug should be taken strictly as prescribed by the doctor: you cannot stop treatment or change medications on your own.Also, to prevent the resistance of microorganisms to the drug, the uroseptic must be changed as prescribed by the doctor during long-term treatment.
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 for the treatment of cystitis in modern clinical practice.
Doctors often prescribe combination drugs 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 constituent drugs for cystitis and enhance 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 physician, urologist or nephrologist often faces the task of choosing the optimal uroseptic for the treatment of a specific case of cystitis.The doctor needs to 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 there are no complications from the kidneys.When diagnosing bladder inflammation in women, the doctor needs to make sure that there is no pregnancy, since 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 activity for cystitis can lead to unwanted complications, weak effect and the development of resistance in microorganisms.