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 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 protection.
The disease has gender characteristics: cystitis occurs more often in women aged 25-40 due to the anatomical and physiological characteristics of the genitourinary system.However, cystitis can occur 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 during urination.An increase in temperature is also possible: cystitis can give any sign 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 considered a serious disease, while its complications can disrupt the functioning of the genitourinary system.The prescription of 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 drugs and, as a result, the transition of acute inflammation to a chronic form with continuous deterioration or sudden development of complications.It should be remembered that the complications of cystitis in women and men lead to pyelonephritis, glomerulonephritis, sphincter dysfunction with constant uncontrolled urination.
The treatment of cystitis should be comprehensive: the features of the clinical picture, test results, medical history and response 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 medications for cystitis
The effect of drugs in the fight against microorganisms is to selectively inhibit or interrupt 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 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 during cystitis.
Classification of uroseptics
I emphasize:
- Herbal medicines for the treatment of cystitis.
- Antibiotics of natural origin (penicillins, cephalosporins of the first and third generation, tetracyclines, glycopeptides).
- Synthetic drugs with antimicrobial activity (quinolone derivatives, fluoroquinolones, sulfonamides, 9-hydroxyquinoline derivatives, nitrofuran derivatives).
- Other antibiotics (trimethoprim), combined 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 dose of drops and capsules.The combination of herbal ingredients provides anti-inflammatory, antispasmodic and antiseptic effects.For pregnant women, it is better to use tablets.
Another popular herbal remedy for cystitis are tablets containing:
- purified mumiyo powder,
- extract of flowers of St.
- saxifrage stem extract,
- madder stem extract,
- Sati membrane rhizome extract,
- strawberry seed extract,
- extract of the aerial part of Onosma bracts,
- Vernonia ashy whole plant extract,
- silicate of lime 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 massive resistance of bacteria to antibacterial agents, there is a need to search for new synthetic analogues of antibiotics with an extended 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 of the typical pathogens of cystitis.It is especially important to prescribe a drug with a wide range of antimicrobial activity in the phase until the exact name of the microbial agent - the causative agent of inflammatory bladder disease - is identified.
PENICILLIN
Penicillin derivatives block the enzymatic system, which 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, 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 can be prescribed to pregnant women if the risk of infection exceeds 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 the 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 broad 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 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 used successfully in the treatment of cystitis.
Important!When choosing an antibiotic, you should focus on the concentration of active ingredients in urine.Then a bactericidal level of the antimicrobial substance is reached in the urine.It is also important that the drug for cystitis in women has little effect on the vaginal microflora, as this creates an additional risk for the 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 respect 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 weight 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 ensure the maximum concentration of the active substance in the organs of the genitourinary system.
Fluoroquinolones
Fluoroquinolones are the last generation of quinolones that inhibit microbial enzymes (DNA gyrase), providing a bactericidal effect on cystitis.Medicines have a wide spectrum of action, affecting even microbes with marked 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 group of fluoroquinolones.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", an antibiotic with a broad spectrum of antimicrobial activity, is widely 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 action on the genitourinary system begins 2-4 hours after taking furadonin, and the percentage 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 were the first 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 sensitive to the action of sulfonamides, and the drugs have a good effect.
Combinations of drugs 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 included in the synthesis of important structural elements of microbial cells.Trimethoprim increases 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 ingredients in urine to fight 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, you must prescribe an antifungal.
For cystitis, medications such as fluconazole, ketoconazole and itraconazole are used.
Characteristics of the choice and use of uroseptic
The patient must remember that the medicine must be taken strictly as prescribed by the doctor: you cannot stop the treatment or change the medicine yourself.Also, to prevent the resistance of microorganisms to the drug, the uroseptic should be changed according to the doctor's recommendation during long-term treatment.
Microbial resistance in cyst develops slowly to drugs from the groups of ampicillin, 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 component drugs for cystitis and increase the effectiveness of therapy.
Herbal antiseptics combine safely and effectively 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 optimal uroseptic for the treatment of a specific case of cystitis.The doctor must 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 determine the stage of inflammation and make sure that there are no complications from the kidneys.When diagnosing bladder inflammation in women, the doctor must make sure that there is no pregnancy, as the medications can be toxic to the unborn child.
Only after the specialist receives answers to all questions, he can choose an effective and safe medicine - injections or tablets.Self-prescription of drugs with uroseptic activity for cystitis can lead to unwanted complications, poor effect and development of resistance in microorganisms.