Cystitis is a very common urological disease in the world. In the vast majority of cases, its development is based on bacterial damage to the internal epithelium of the bladder. Therefore, antibiotics for cystitis in women are widely used as drugs of choice for this pathology.
Antibiotics for acute cystitis.
Before deciding which antibiotic to prescribe, an experienced doctor should carefully study and examine the patient. To diagnose acute cystitis, blood and urine tests are recommended. But it is not always necessary to accurately determine the type of pathogen. Antibiotic therapy is first carried out empirically and preference is given to broad-spectrum drugs from the list of recommendations of the urological association. It is important to note that only a doctor has the right to prescribe any antibacterial medication and self-medication often leads to complications.
For a long time, the drug of choice was a combination of sulfonamide and a dihydrofolate reductase inhibitor. But prolonged use of this drug has caused an increase in the resistance of microorganisms to it and a decrease in the effectiveness of the therapy. Therefore, modern European recommendations recommend the use of other antibacterial agents. First of all, they give preference to:
- fluoroquinolones;
- nitrofurans;
- Medicine based on phosphonic acid.
The treatment is carried out on an outpatient basis under the supervision of a urologist. A few days after the start of therapy, the tests are repeated. The minimum duration of treatment with fluoroquinoles is 3 days, nitrofurans - 7 days, and the phosphonic antibiotic is taken only once.
Antibiotics for chronic cystitis.
When the infection progresses to a chronic stage, empiric antibiotic therapy is unacceptable. It is mandatory to conduct a microbiological examination of urine before prescribing antibacterial drugs. It also studies the resistance of a bacterial strain to specific therapeutic agents. This allows the treating doctor to select antibiotics for chronic cystitis that will be most effective for a particular patient.
There is an opinion that this form of pathology is rarely an independent disease. Therefore, such a patient must undergo a complete examination of not only the genitourinary organs, but also other body systems. Particular attention is paid to possible immune disorders and foci of chronic infection in the body.
Predominantly fluoroquinolones or other reserve drugs from the list are prescribed: tetracyclines, third generation cephalosporins, macrolides. The course of its reception lasts at least 7 days. At the same time, it should be supplemented with various non-drug treatment methods:
- surgical intervention due to anatomical defects and/or presence of chronic infection foci;
- careful hygiene;
- selection of comfortable underwear;
- treatment of immunological disorders;
- temporary abstinence from sexual contact.
Prevention of recurrence of cystitis.
Antibiotics are used not only to treat the acute phase of cystitis, but also to prevent relapses of the disease. It is recommended for patients who have had more than 2 exacerbations during the last 6 months.
There are several regimens for taking antibacterial drugs. The most common of these is the prescription of long-term low-dose treatment during remission. Use one of the drugs from the group of fluoroquinolones (0. 2 g each), nitrofurans (0. 1 g each) or a phosphonic antibiotic (3. 0 g each) every 10 days for 3 months.
If there is a relationship between recurrent cystitis and sexual intercourse, the doctor recommends taking one of the medications mentioned above after intercourse. In some cases, if symptoms appear, the patient can repeat the treatment at her expense.
However, upon completion, it is necessary to undergo urine analysis for bacteriological examination. It is also important to remember that the prevention of cystitis is effective only in the absence of abnormalities in the development of the urinary tract and other infectious processes in the body.
Selected antibacterial drugs for cystitis.
Phosphonic antibiotic
The product contains phosphonic acid and is widely used to treat bacterial infections of the lower urinary tract. The drug has a strong bactericidal effect against E. coli, enterococci, staphylococci, Klebsiella, Proteus and other pathogens. Available in the form of powder sachets.
This remedy should be used once 2 hours after meals before going to bed. In this case, you must first mix the contents of the bag with a small amount of water (about a third of a glass). A single dose for adults is 3. 0 g of the drug. In some cases, it is necessary to repeat the medication after 24 hours.
Phosphonic acid is practically not metabolized in the patient's body and most of it is excreted by the kidneys. In this case, in the urine, 4-6 hours after administration, a therapeutic concentration of the drug is achieved, which persists for more than two days. In addition, the drug has a number of advantages:
- single use convenience;
- low rates of side effects when used;
- limited contraindications (severe renal failure, children under 5 years of age);
- The drug is approved for use during pregnancy.
nitrofurans
Nitrofurans, together with a phosphonic antibiotic, are the drugs of choice for acute cystitis. They have a bactericidal effect on most of the pathogens of this pathology. At the same time, the resistance of bacteria to nitrofurans remains at a low level. The disadvantages of this group of antimicrobial agents include the frequent occurrence of side effects:
- dyspeptic disorders (nausea, vomiting);
- abdominal pain of variable intensity;
- dizziness;
- drowsiness;
- toxic effects on the liver and kidneys.
Take nitrofuran preparations 3 times a day, 100 mg. The duration of treatment is 5 to 7 days.
Fluoroquinolones
This group of antibacterial drugs is a derivative of nalidixic acid. Fluoroquinolones have a bactericidal effect against a wide range of bacteria. When used internally, they quickly enter the bloodstream and begin to work within an hour. They are excreted from the body through the kidneys, which explains their widespread use in urology.
The use of fluoroquinolones in children under 18 years of age, pregnant and lactating mothers is prohibited. This is due to its negative impact on the formation of the musculoskeletal system. Contraindications also include a history of seizures, epilepsy and individual intolerance. In recent years, fluoroquinolones are mainly taken when phosphonic antibiotics and nitrofurans are ineffective, as well as in complicated forms of cystitis.
Fluoroquinolones should be taken 2 times a day for 3 days.
However, recently these drugs are practically not prescribed for cystitis due to the fact that bacteria have developed resistance to the fluoroquinolone group in 60% of cases.
Cephalosporins
Cephalosporins are beta-lactam antibiotics with a bactericidal effect. Today there are five generations of these drugs, but only the first three are used in urology. Cephalosporins are considered one of the safest drugs among antibacterial agents.
The only important contraindication for its use is the presence of hypersensitivity in the patient to beta-lactams (various allergic reactions develop). This allows the use of cephalosporins in young children, pregnant women and the elderly.
First generation drugs are rarely used due to the resistance of microorganisms. The third generation drug is prescribed at 0. 4 g 1 time or 0. 2 g 2 times a day for adults. The dosage for children depends on their age and body weight.
tetracyclines
This group of drugs belongs to synthetic antibiotics. Tetracyclines have a bacteriostatic effect, that is, they inhibit the proliferation of microorganisms. Today they are used to treat cystitis when standard therapy with phosphonic antibiotics and nitrofurans has proven to be ineffective.
Among the disadvantages of tetracyclines, their side effects are often mentioned: nephrotoxicity, dyspepsia, increased intracranial pressure, dizziness, inhibition of hematopoiesis, toxic hepatitis and others. In addition, drugs in this group disrupt the formation of bone tissue, so they should not be prescribed to children, pregnant and lactating mothers.
Take 0. 1 g once or twice a day. It is recommended to additionally monitor kidney and liver function every 3 days after taking the drug.
penicillins
Penicillins have limited use for cystitis. This is due to a decrease in effectiveness due to the development of resistance in microorganisms.
However, penicillins have high safety indicators, which allows their therapeutic use in children and pregnant women.
Side effects usually include digestive disorders, which disappear quickly after stopping the medication. The duration of using penicillins for cystitis is up to 7 days.