Cystitis is a very common urological disease in the world. In the vast majority of cases, its formation is based on bacterial damage to the inner epithelium of the bladder. Therefore, antibiotics for the treatment of cystitis in women are widely used as the drugs of choice for this pathology.
Antibiotics for the treatment of acute cystitis
Before deciding which antibiotic to prescribe, an experienced doctor should thoroughly examine and examine the patient. To diagnose acute cystitis, a blood and urine test is recommended. But it is not always necessary to precisely determine the type of pathogen. Antibiotic therapy is first carried out empirically, and broad-spectrum drugs are preferred among the recommendations of the urological association. It is important to remember that only a doctor has the right to prescribe any antibacterial drugs, 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 led to an increase in the resistance of microorganisms and a decrease in the effectiveness of therapy. Therefore, modern European recommendations recommend the use of other antibacterial agents. First of all, preference is given to:
- fluoroquinolones;
- nitrofurans;
- a phosphonic acid-based drug.
The treatment is performed on an outpatient basis under the supervision of a urologist. A few days after starting the therapy, the tests are repeated. The minimum duration of treatment for fluoroquinols is 3 days, nitrofurans - 7 days, and the phosphonic antibiotic should be taken only once.
Antibiotics to treat chronic cystitis
When the infection becomes chronic, empiric antibiotic therapy is unacceptable. Before prescribing antibacterial drugs, a microbiological examination of the urine is mandatory. It also examines the resistance of a bacterial strain to specific therapeutic agents. This allows the attending physician to choose antibiotics for chronic cystitis that are 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 urinary organs, but also of other body systems. Special attention is paid to possible immune system disorders and foci of chronic infections in the body.
Fluoroquinolones or other reserve drugs from the list are predominantly prescribed - tetracyclines, third-generation cephalosporins, macrolides. Their collection takes at least 7 days. At the same time, it must be supplemented with various non-pharmacological treatment methods:
- surgical intervention in the presence of anatomical defects and/or chronic infection foci;
- careful hygiene;
- choosing comfortable underwear;
- treatment of immune system 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 relapse of the disease. It is recommended for patients who have had more than 2 exacerbations in the past 6 months.
There are many ways to take antibacterial drugs. The most common of these is the prescription of long therapy in low doses during remission. Use one of the fluoroquinolones (0. 2 g each), nitrofurans (0. 1 g each), or a phosphonic antibiotic (3. 0 g) every 10 days for 3 months.
If there is a connection between recurrent cystitis and sexual intercourse, the doctor will recommend one of the above-mentioned medications after intercourse. In some cases, if symptoms appear, the patient can repeat the treatment independently.
However, after this is completed, a urinalysis must be performed for bacteriological examination. It is also important to remember that the prevention of cystitis is effective only in the absence of abnormalities in the development of the urinary tract and other infectious processes in the body.
Selected antibacterial drugs for cystitis
Phosphonic 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 after a meal, 2 hours before going to bed. In this case, the contents of the bag must first be mixed in a small amount of water (about a third of a glass). A single dose for adults is 3. 0 g of the drug. In some cases, it is necessary to repeat the medicine after 24 hours.
Phosphonic acid is practically not metabolized in the patient's body, and most of it is excreted through the kidneys. In this case, a therapeutic concentration of the drug can be reached in the urine 4-6 hours after administration, which persists for more than two days. In addition, the drug has many advantages:
- convenience of single use;
- low rate of side effects during use;
- limited contraindications (severe renal failure, children under 5);
- the drug is approved for use during pregnancy.
Nitrofurans
Nitrofurans, along with a phosphonic antibiotic, are the drugs of choice for the treatment of acute cystitis. They have a bactericidal effect on most pathogens of this pathology. At the same time, the resistance of bacteria to nitrofurans remains at a low level. Disadvantages of this group of antimicrobials 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 three times a day, 100 mg. The duration of the treatment is 5-7 days.
Fluoroquinolones
This group of antibacterial drugs is a derivative of nalidixic acid. Fluoroquinolones are bactericidal against many bacteria. When used internally, they quickly enter the bloodstream and begin to work within an hour. They are excreted from the body through the kidneys, which explains their wide use in urology.
Fluoroquinolones are prohibited for children under the age of 18, pregnant and nursing mothers. This is due to their negative impact on the development of the locomotor system. Contraindications also include a history of convulsions, epilepsy and individual intolerance. In recent years, fluoroquinolones are mainly used 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 cystitis, since bacteria have developed resistance to the fluoroquinolone group in 60% of cases.
Cephalosporins
Cephalosporins are beta-lactam antibiotics with a bactericidal effect. Today there are 5 generations of these drugs, but only the first three are used in urology. Cephalosporins are considered one of the safest antibacterial drugs.
The only major contraindication to their use is the patient's hypersensitivity to beta-lactams (various allergic reactions develop). This allows the use of cephalosporins in young children, pregnant women and the elderly.
First-generation drugs are rarely used due to the resistance of microorganisms. The third generation drug is prescribed 0. 4 g 1 time or 0. 2 g twice a day for adults. The dose for children depends on their age and body weight.
Tetracyclines
This group of drugs belongs to synthetic antibiotics. Tetracyclines have a bacteriostatic effect, i. e. they inhibit the growth of microorganisms. Today, it is 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 belonging to this group interfere with the formation of bone tissue, so they cannot be prescribed to children, pregnant and lactating mothers.
Take 0. 1 g once or twice a day. After taking the drug, further monitoring of kidney and liver function is recommended every 3 days.
Penicillins
Penicillin drugs are of limited use in the treatment of cystitis. The reason for this is the decrease in efficiency due to the development of resistance of microorganisms.
However, penicillins have high safety indicators, which allows their use in the therapy of children and pregnant women.
Side effects are often indigestion, which disappear quickly after stopping the drug. The duration of the use of penicillins for cystitis is no more than 7 days.