The cause of infectious cystitis is the action of pathogenic microorganisms, which, as a result of their vital activity, provoke an inflammatory process.Pathogens can come from 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 occurs more often in women aged 25 to 40 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.It is also possible to increase the temperature: cystitis can give any signs of general inflammation.
The triggering factor for the development of the disease is usually hypothermia and then the 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 disrupt the functioning of the genitourinary system.Prescribing antimicrobial medications 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 to chronic form with constant exacerbations or sudden development of complications.It should be remembered that complications of cystitis in women and men lead to pyelonephritis, glomerulonephritis, sphincter dysfunction with constant and uncontrolled urination.
Treatment of cystitis should be comprehensive: the characteristics of the clinical picture, test results, medical history and reaction to medications are taken into account.However, the mainstay of the treatment regimen for both women and men always remains a natural or synthetic antimicrobial medicine.
Antimicrobial medications 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.The viral origin of cystitis is rare.It is quickly complicated by the addition of a bacterial infection, therefore, in any case, the disease requires the prescription of antibiotics.
A group of drugs effective in the treatment of inflammatory processes in the genitourinary system is called “uroseptics”.Antiseptics, synthetic antimicrobial agents, and uroseptic category antibiotics are excreted by the kidneys.This creates an effective therapeutic concentration of the drug at the site of inflammation during cystitis.
Classification of uroseptics
Emphasis:
- Herbal medicines for the treatment of cystitis.
- Antibiotics of natural origin (penicillins, first and third generation cephalosporins, tetracyclines, glycopeptides).
- Synthetic drugs with antimicrobial activity (quinolone derivatives, fluoroquinolones, sulfonamides, 9-hydroxyquinoline derivatives, nitrofuran derivatives).
- Other antibiotics (trimethoprim), combination antimicrobial medicines.
- Antifungal medications.
Vegetable uroseptics
Centaur Herb + Lovage Root + Rosemary Leaves - this is a composition of a medicine from the herbal medicine group, which has proven its clinical effectiveness in practice.A universal remedy based on rosemary, centaur and almond is available in two forms: alcohol solution in drops and capsules.The combination of herbal components provides anti-inflammatory, antispasmodic and antiseptic effects.For pregnant women, it is best to use pills.
Another popular herbal medicine for cystitis are tablets containing:
- purified mumiyo powder,
- St. Louis flower extract
- saxifrage stem extract,
- madder stem extract,
- extract of membranous Sati rhizomes,
- straw seed extract,
- extract from the aerial part of Onosma bracts,
- vernonia ash whole plant extract,
- lime silicate powder.
The drug has antimicrobial, antispasmodic, anti-inflammatory, analgesic and diuretic effects for cystitis.
Antibiotics
A group of natural antibiotics were widely used before the era of antibiotic resistance.With the enormous resistance of bacteria to antibacterial agents, there is a need to search for new synthetic analogues of antibiotics with a broader spectrum of activity and a low risk of developing resistance.
However, some cases of cystitis require the prescription of medicines from the group of natural antibacterials.State-of-the-art broad-spectrum antibiotics are used, effective against most typical cystitis pathogens.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 bladder disease - is identified.
Penicillins
Penicillin derivatives block the enzyme system, which serves as the basis for the formation of the cell wall.The medicines have a bactericidal effect.To increase effectiveness, penicillin-based drugs are combined with clavulanic acid.It inhibits the beta-lactamase system, further promoting the destruction of the cell wall of microorganisms.In urology, semi-synthetic representatives of the group “protected” by clavulanic acid are used.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 prescribing medications mainly not in tablets, but in injectable forms, which guarantees 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 are prescribed - cefixime, ceftibuten.
Phosphonic acid derivatives
Fosfomycin is a broad-spectrum antibiotic that has been shown to be 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 to 48 hours, the drug can be used successfully in the treatment of cystitis.
Important!When choosing an antibiotic, you need to focus on the concentration of active components in the urine.A bactericidal level of the antimicrobial substance in the urine is then achieved.It is also important that the medication for cystitis in women has little effect on the vaginal microflora, as this creates an additional risk of progression or recurrence of cystitis.
Antibiotic combinations are effective for cystitis (trimethoprim in combination with sulfamethoxazole) and even fight 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 longer, 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.The drugs have a wide spectrum of action, affecting even microbes with pronounced resistance to other antibacterial agents.
High bioavailability, low probability of side effects and good tolerability are the reasons for frequent prescription of this group of antibiotics for cystitis.
Ciprofloxacin is the most popular uroseptic tablet from the fluoroquinolone group.Its clinical effects have been well studied.You can find these trade names of the active substance.
Norfloxacin and Levofloxacin are also used to treat cystitis.
Nitrofuran derivatives
In urological practice, the drug “Furagin”, an antibiotic with a wide spectrum of antimicrobial activity, is widely used.The level of the drug in urine is several times higher than the minimum bacteriostatic concentration for pathogenic microbes in the treatment of cystitis.
Nitrofurantoin is the second best-known representative of the group.The active ingredient is nitrofurantoin.It is rapidly excreted in the urine, the action on the genitourinary system begins 2–4 hours after ingestion of 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 gram-positive or gram-negative aerobic microflora.
Sulfonamides and their combinations
This group of synthetic antibiotics was the first of the chemical alternatives to natural 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.
Medication combinations are also often prescribed.Thanks to this, a better treatment effect can be achieved.A well-known representative of the group of combined 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 potentiates the effect of sulfamethoxazole by interfering with the production of folic acid.This significantly disrupts the metabolism of bacterial cells and leads to their death.
The medicine 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
Medicines are prescribed if the fungal nature of cystitis is confirmed or to prevent fungal infections during antibiotic treatment.Candidiasis is one of the common complications of antibacterial therapy.To prevent or treat it successfully, it is necessary to prescribe an antimycotic.
For cystitis, medications such as fluconazole, ketoconazole and itraconazole are used.
Features of the selection and use of uroseptics
The patient must remember that the medicine must be taken strictly as prescribed by the doctor: you cannot interrupt treatment or change medicines on your own.Furthermore, to prevent resistance of microorganisms to the drug, the uroseptic should be changed as prescribed by the doctor during prolonged 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 for the treatment of cystitis in modern clinical practice.
Doctors often prescribe combination medications or multiple medications at once.Combinations of furagin with chloramphenicol or sulfonamides, as well as combinations of sulfanilamide with chloramphenicol, expand the spectrum of action of constituent drugs for cystitis and increase 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 doctor, urologist or nephrologist is often faced with the task of choosing the ideal 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 kidney complications.When diagnosing bladder inflammation in women, the doctor needs to be sure that there is no pregnancy, as medications can be toxic to the fetus.
Only after the specialist receives answers to all questions will he be able to choose an effective and safe medicine - injections or tablets.Self-prescription of drugs with uroseptic activity for cystitis can lead to undesirable complications, weak effect and development of resistance in microorganisms.