The cause of infectious cystitis is the action of pathogenic microorganisms, which, due to their vital activity, cause an inflammatory process.Pathogens can come from the 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 defenses.
The disease has gender characteristics: cystitis most often occurs in women aged 25-40 years 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 lining: the first sign is usually pain in the lower abdomen, burning, itching, frequent urges and pain when urinating.An increase in temperature is also possible: cystitis can give signs of general inflammation.
The triggering factor for the development of the disease is generally hypothermia, followed by a reduction in the body's defenses.Cystitis can also be provoked by changes in sexual activity and other causes of disruption of normal vaginal microflora.
Cystitis in women: treatment
The difficulty of treatment lies in the fact 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 from acute inflammation to a 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, dysfunction of the sphincters with constant and uncontrolled urination.
Treatment of cystitis should be comprehensive: the features of the clinical picture, test results, medical history and reaction to medications are taken into account.However, the basis of the treatment regimen for both women and men still 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 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 quickly becomes complicated by the addition of a bacterial infection, so in all cases 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 antibiotics in 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
Highlight:
- 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), combined antimicrobial drugs.
- Antifungal medications.
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 comes in two forms: an alcoholic solution dosed in drops and capsules.The combination of herbal components provides anti-inflammatory, antispasmodic and antiseptic effects.For pregnant women it is better to use tablets.
Another popular herbal medicine for cystitis are tablets containing:
- purified mumiyo powder,
- flower extract of St.
- saxifrage stem extract,
- madder stem extract,
- extract of membranous Sati rhizomes,
- strawberry seed extract,
- extracted 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 massive resistance of bacteria to antibacterial agents, it becomes necessary to search for new synthetic analogues of antibiotics with an expanded 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, effective against most pathogens typical of cystitis.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 enzymatic system which serves as the basis for the formation of the cell wall.The drugs have a bactericidal effect.To improve 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 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 drugs mainly not in tablet form, but in injectable forms, which guarantees 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 (third generation drugs with a broad spectrum of antibacterial activity) are prescribed.Simple forms of cystitis in women and men can be treated without injections: tablets of third-generation cephalosporin antibiotics - cefixime, ceftibuten - are prescribed.
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 of the tablet is fosfomycin trometamol.Its molecule inhibits the first step in microbial cell wall formation.Due to the high concentration of the drug in urine, which is maintained for 24-48 hours, the drug can be successfully used in the treatment of cystitis.
Important!When choosing an antibiotic, you should focus on the concentration of active components in urine.Then, a bactericidal level of antimicrobial substance in the urine is reached.It is also important that the drug 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 against cystitis (trimethoprim in combination with sulfamethoxazole) and even fight rare pathogenic microorganisms (S. saprophyticus).It is important to respect the treatment regimen and duration of antibiotic treatment.The duration of treatment can range from 3 to 14 days or more, depending on the complexity and severity of the case.
Synthetic uroseptics
All synthetic agents acting 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.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 the 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 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 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 well-known representative of the group.The active ingredient is nitrofurantoin.It is quickly excreted in urine, the action in the genitourinary system begins 2-4 hours after taking furadonin, and the proportion of unchanged drug in urine is approximately 45%.It gives a good effect in the treatment of simple 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 chemical alternative to natural antibiotics.For some time, representatives of the sulfonamide series remained in reserve due to the prescription of other groups of drugs.Therefore, the causative agents of infectious cystitis are now sensitive to the action of sulfonamides and the drugs have a good effect.
Combinations of medications are also often prescribed.Through this, a better treatment effect can be achieved.A well-known representative of the group of combined drugs that includes sulfamethoxazole and trimethoprim.
Sulfamethoxazole has a chemical structure similar to para-aminobenzoic acid (PABA), which allows the drug to be involved in the synthesis of important structural elements of microbial cells.Trimethoprim enhances 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 drug has a wide spectrum of action, and also creates the necessary level of active components in urine to combat infections of the genitourinary system.The duration of treatment for simple cystitis is 6 days.It is important to strictly adhere to the duration of antibiotic treatment for successful cure and prevention of recurrence of infection.
Antifungal medications (antimycotics)
Medications are prescribed if the fungal nature of cystitis is confirmed or to prevent fungal infections during treatment with antibiotics.Candidiasis is one of the common complications of antibacterial treatment.To prevent it or successfully treat it, an antimycotic must be prescribed.
For cystitis, drugs such as fluconazole, ketoconazole and itraconazole are used.
Features of the selection and use of uroseptics
The patient must remember that the medication must be taken strictly as prescribed by the doctor: you cannot stop treatment or change medications on your own.In addition, to prevent resistance of microorganisms to the drug, the uroseptic should be changed as prescribed by the doctor during long-term treatment.
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 the same time.Combinations of furagin with chloramphenicol or sulfonamides, as well as combinations of sulfanilamide with chloramphenicol, expand the spectrum of action of drugs constituting cystitis and improve the effectiveness of treatment.
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 optimal uroseptic for the treatment of a specific case of cystitis.The doctor should determine the localization of the infectious process and, if possible, know 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 that there are no kidney complications.When diagnosing bladder inflammation in women, the doctor must ensure that there is no pregnancy, as medications can be toxic to the unborn child.
Only after the specialist receives answers to all questions can he choose an effective and safe drug - injections or tablets.Self-prescription of drugs with uroseptic activity for cystitis can lead to unwanted complications, weak effect and the development of resistance in microorganisms.