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 inner 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 initially carried out empirically, and broad-spectrum drugs from the urological association's list of recommendations are preferred. 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 the 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 the treatment. Therefore, modern European recommendations recommend the use of other antibacterial agents. First of all, they prefer:
- fluoroquinolones;
- Nitrofurans?
- phosphonic acid-based drug.
Treatment is carried out in outpatient clinics under the supervision of a urologist. A few days after the start of the treatment, the tests are repeated. The minimum duration of treatment for fluoroquinols is 3 days, nitrofurans - 7 days, and a phosphonate antibiotic is taken only once.
Antibiotics for chronic cystitis
When the infection progresses to the chronic stage, empiric antibiotic therapy is unacceptable. It is mandatory to carry out a microbiological examination of the urine before prescribing antibacterial drugs. It also studies the resistance of a bacterial strain to specific therapeutic agents. This allows the treating physician to choose 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 should have a comprehensive examination not only of the genitourinary organs, but also of other body systems. Special attention is paid 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 course of their reception lasts at least 7 days. At the same time, it should be supplemented with various non-pharmacological methods of treatment:
- surgery for anatomical defects and/or the presence of foci of chronic infection.
- careful hygiene;
- choice of comfortable underwear.
- treatment of immune disorders;
- temporary abstinence from sexual intercourse.
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 in the last 6 months.
There are various regimens for taking antibacterial drugs. The most common of these is the prescription of a long course of treatment at low doses during remission. Use one of the drugs from the group of fluoroquinolones (0. 2 g each), nitrofurans (0. 1 g each), or a phosphonate antibiotic (3. 0 g each) every 10 days for 3 months.
If there is a connection between recurrent cystitis and sexual intercourse, the doctor recommends taking one of the above-mentioned drugs after intercourse. In some cases, if symptoms appear, the patient can repeat the course of treatment on his own.
However, after its completion, you must undergo a urine test for bacteriological examination. It is also important to remember that the prevention of cystitis is effective only if there are no abnormalities in the development of the urinary system and other infectious processes in the body.
Selected antibacterial drugs for cystitis
Phosphonate 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. It is available in the form of powder sachets.
This medicine should be used once 2 hours after meals 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 the glass). A single dose for adults is 3. 0 g of the drug. In some cases, you need to repeat the medicine 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, child under 5 years).
- the drug is approved for use during pregnancy.
Nitrofurans
Nitrofurans, along with a phosphonate antibiotic, are the drugs of choice for acute cystitis. They have a bactericidal effect on most pathogens of this pathology. At the same time, bacterial resistance 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 varying intensity.
- dizziness;
- drowsiness;
- toxic effects on the liver and kidneys.
Take nitrofuran preparations 3 times a day, 100 mg. The duration of treatment is from 5 to 7 days.
Fluoroquinolones
This group of antibacterial drugs is a derivative of nalidixic acid. Fluoroquinolones have bactericidal activity against a wide range of bacteria. When used internally, they quickly enter the bloodstream and start working within an hour. They are removed from the body by the kidneys, which explains their widespread use in urology.
Fluoroquinolones are prohibited for use by children under 18, pregnant and nursing mothers. This is due to their 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 taken mainly when phosphonate 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 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 bactericidal activity. Today, there are 5 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 significant contraindication to their use is the presence of hypersensitivity to beta-lactams in the patient (various allergic reactions develop). This allows cephalosporins to be used in young children, pregnant women and the elderly.
First-generation drugs are rarely used because of the resistance of microorganisms. The third generation drug is prescribed 0. 4 g 1 time or 0. 2 g 2 times a day for adults. 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. They are now used to treat cystitis when standard treatment with phosphonate antibiotics and nitrofurans has proven ineffective.
Among the disadvantages of tetracyclines, their side effects are often mentioned: nephrotoxicity, indigestion, increased intracranial pressure, dizziness, inhibition of hematopoiesis, toxic hepatitis and others. Also, drugs of this group disrupt the formation of bone tissue, so they should not be prescribed to children, pregnant and nursing mothers.
Take 0. 1 g once or twice a day. Additional monitoring of kidney and liver function is recommended every 3 days after taking the drug.
penicillins
Penicillin drugs 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 them to be used for the treatment of children and pregnant women.
Adverse effects often include digestive disturbances, which disappear quickly after stopping the drug. The duration of use of penicillins for cystitis is up to 7 days.