Cystitis is a very common urinary disease in the world. In the majority of cases, its development is based on bacterial damage to the internal epithelium of the bladder. Therefore, antibiotics are widely used to treat cystitis in women and are the drugs of choice for this disease.
Antibiotics treat acute cystitis
Before deciding which antibiotic to prescribe, an experienced doctor should research and examine the patient thoroughly. To diagnose acute cystitis, blood and urine tests should be performed. But it is not always necessary to accurately determine the type of pathogen. Antibiotic treatment was first performed empirically and with priority given to the use of broad-spectrum drugs from the urological association's recommended list. It is important to note that only a doctor has the right to prescribe any antibacterial drug, and self-medication often leads to complications.
For a long time, the drug of choice was a combination of a sulfonamide and a dihydrofolate reductase inhibitor. But long-term use of this drug has led to an increase in the resistance of microorganisms to it and a decrease in the effectiveness of therapy. Therefore, modern European recommendations recommend the use of other antibacterial agents. First of all, they prioritize:
- fluoroquinolone;
- nitrofuran;
- drugs based on phosphonic acid.
Treatment is performed on an outpatient basis under the supervision of a urologist. A few days after starting treatment, the tests are repeated. The minimum duration of treatment for fluoroquinols is 3 days, nitrofurans - 7 days, and phosphonic antibiotics are administered only once.
Antibiotics treat chronic cystitis
When the infection progresses to the chronic stage, empiric antibiotic treatment is unacceptable. It is mandatory to conduct a urine microbiological examination before prescribing antibacterial drugs. It also studies the resistance of a bacterial strain to specific therapeutic agents. This allows the attending physician to choose the antibiotic 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 needs a comprehensive examination of not only the genital organs, but also other body systems. Pay special attention to possible immune disorders and foci of chronic infection in the body.
Fluoroquinolones or other reserve drugs from the list are mainly prescribed - tetracyclines, third generation cephalosporins, macrolides. The process of taking them lasts at least 7 days. At the same time, more non-drug treatment methods need to be added:
- surgical intervention for anatomical defects and/or the presence of chronic infection foci;
- careful cleaning;
- choose comfortable underwear;
- treatment of immune disorders;
- Temporarily abstain from sex.
Preventing recurrent cystitis
Antibiotics are used not only to treat the acute phase of cystitis, but also to prevent its recurrence. It is recommended for patients who have had more than 2 exacerbations in the past 6 months.
There are several antibacterial regimens. The most common of them is to prescribe a long course of treatment at a low dosage during the period of remission. Use one of the fluoroquinolones (0. 2 g each), nitrofurans (0. 1 g each), or phosphonic antibiotics (3. 0 g each) every 10 days for 3 months.
If there is a connection between recurrent cystitis and sexual intercourse, your doctor recommends taking one of the above medications after intercourse. In some cases, if symptoms appear, the patient can repeat the treatment on his own.
However, once completed, you must undergo a urine test to check for bacteria. It is important to remember that preventing cystitis is effective only when there are no abnormalities in the development of the urinary tract and other infectious processes in the body.
Antibacterial drugs of choice for cystitis
Phosphonic antibiotics
The product contains phosphonic acid and is widely used to treat lower urinary tract infections. The drug has a strong bactericidal effect against E. coli, enterococci, staphylococci, Klebsiella, Proteus and other pathogens. Available in powder packet form.
This remedy should be taken once after meals 2 hours before going to bed. In this case, the contents of the bag must first be mixed with a small amount of water (about a third of a glass). The single dose for adults is 3. 0 g of the drug. In some cases, you may need to repeat the medication after 24 hours.
Phosphonic acid is practically not metabolized in the patient's body and is largely excreted through the kidneys. In this case, in urine, 4-6 hours after administration, therapeutic concentrations of the drug are achieved and persist for more than two days. In addition, the drug also has a number of advantages:
- convenience of single use;
- low rate of side effects when used;
- Limited contraindications (severe renal failure, children under 5 years old);
- The drug is approved for use during pregnancy.
Nitrofuran
Nitrofurans, along with phosphonic antibiotics, are the drugs of choice for acute cystitis. They have a bactericidal effect against most pathogens of this pathology. At the same time, bacterial resistance to nitrofurans remains low. The disadvantages of this group of antimicrobial drugs include the frequent occurrence of side effects:
- dyspeptic disorders (nausea, vomiting);
- abdominal pain of varying intensity;
- dizzy;
- asleep;
- toxic effects on the liver and kidneys.
Take the nitrofuran preparation 3 times a day, 100 mg. The duration of treatment is from 5 to 7 days.
Fluoroquinolone
This group of antibacterial drugs is a derivative of nalidixic acid. Fluoroquinolones have a bactericidal effect against many types of bacteria. When used internally, they quickly enter the bloodstream and begin working within an hour. They are eliminated from the body through the kidneys, which explains their widespread use in urology.
Fluoroquinolones are prohibited for use in children under 18 years of age, pregnant and lactating mothers. This is due to their negative impact on the formation of the musculoskeletal system. Contraindications also include a history of convulsions, epilepsy and individual intolerance. In recent years, fluoroquinolones have been used mainly when phosphonic antibiotics and nitrofurans are ineffective, as well as in complicated forms of cystitis.
Fluoroquinolones should be taken twice a day for 3 days.
However, recently these drugs are practically not prescribed for bacterial cystitis that has developed resistance to the fluoroquinolone group in 60% of cases.
Cephalosporins
Cephalosporin is a beta-lactam antibiotic with bactericidal effect. Today, there are 5 generations of this drug, but only the first 3 generations are used in urology. Cephalosporin is considered one of the safest drugs among antibacterial agents.
The only significant contraindication to their use is the presence of patients with hypersensitivity to beta-lactams (development of various allergic reactions). This allows the use of cephalosporins in young children, pregnant women and the elderly.
First generation drugs are rarely used due to microbial resistance. Third generation drugs are prescribed 0. 4 g 1 time or 0. 2 g 2 times a day for adults. Dosage for children depends on age and body weight.
Tetracycline
This group of drugs belongs to the group of synthetic antibiotics. Tetracyclines have a bacteriostatic effect, meaning they inhibit the growth of microorganisms. Today they are used to treat cystitis when standard therapy with phosphonic antibiotics and nitrofurans has proven 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 of this group disrupt the process of bone tissue formation, so they should not be prescribed to children, pregnant and lactating mothers.
Take 0. 1 g once or twice a day. Additional monitoring of kidney and liver function is recommended every 3 days of administration.
Penicillin
Penicillin is of limited use in the treatment of cystitis. This is due to a decrease in effectiveness due to the development of microbial resistance.
However, penicillin has a high safety index so it can be used to treat children and pregnant women.
Side effects often include digestive upset, which quickly disappears after stopping the drug. The duration of using penicillin to treat cystitis is up to 7 days.