Cystitis is a very common urological disease in the world. In most 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 the drug of choice for this pathology.
Antibiotics for acute cystitis
Before deciding which antibiotic to prescribe, an experienced doctor should study and examine the patient carefully. To diagnose Acute Cystitis, it is recommended to conduct blood and urine tests. But it is not always necessary to accurately determine the type of pathogen. Antibiotic therapy is first carried out empirically, and priority is given to broad-spectrum drugs from the list of recommendations of the urological association. It is important to note that only a doctor has the right to prescribe any antibacterial drugs, and the drugs themselves often lead 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 therapy. Therefore, modern European recommendations recommend the use of other antibacterial agents. First of all, they give priority to:
- fluoroquinolones;
- nitrofurans;
- phosphonic acid-based drugs.
Treatment is carried out on an outpatient basis under the supervision of a urologist. A few days after the start of therapy, the test is repeated. The minimum duration of therapy for fluoroquinols is 3 days, nitrofurans - 7 days, and phosphonic antibiotics are taken only once.
Antibiotics for chronic cystitis
When the infection progresses to a chronic stage, empirical 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 bacterial strains to certain therapeutic agents. This allows the attending physician to choose the most effective antibiotic for chronic cystitis for a particular patient.
There is an opinion that this form of pathology is rarely an independent disease. Therefore, such patients should have a comprehensive examination of not only the genitourinary organs, but also other body systems. Special attention is paid to possible immune disorders and the focus of chronic infections in the body.
Fluoroquinolones or other reserve drugs from the list are mostly prescribed - tetracyclines, third generation cephalosporins, macrolides. The course of taking them lasts at least 7 days. At the same time, it should be supplemented with various non-drug treatment methods:
- surgical intervention for anatomical defects and/or the presence of chronic infection foci;
- scrupulous cleanliness;
- selection of comfortable underwear;
- treatment of immune disorders;
- temporary abstinence from sexual intercourse.
Prevention of recurrent cystitis
Antibiotics are used not only to treat the acute phase of cystitis, but also to prevent recurrence of the disease. It is recommended for patients who have had more than 2 exacerbations in the past 6 months.
There are several regimens for taking antibacterial drugs. The most common of them is the prescription of a long course of therapy in low doses during remission. Use one of the drugs from the group of fluoroquinolones (0. 2 g each), nitrofurans (0. 1 g each) or phosphonic antibiotics (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 completion, you must undergo a urine test for bacteriological examination. It is also important to remember that the prevention of cystitis is only effective if there are no abnormalities in the development of the urinary tract and other infectious processes in the body.
Selective antibacterial drugs for cystitis
Phosphonic antibiotics
This product contains phosphonic acid and is widely used to treat bacterial infections of the lower urinary tract. This drug has a strong antibacterial effect against E. coli, enterococci, staphylococci, Klebsiella, Proteus and other pathogens. Available in the form of powder sachets.
This medicine should be used once 2 hours after eating 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). One 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 is mostly excreted by the kidneys. In this case, in the urine, 4-6 hours after administration, the therapeutic concentration of the drug is reached, which persists for more than two days. In addition, this drug has several advantages:
- convenience of single use;
- low rate of side effects when used;
- limited contraindications (severe renal failure, children under 5 years of age);
- the drug is approved for use during pregnancy.
Nitrofurans
Nitrofurans, along with phosphonic antibiotics, are the drugs of choice for acute cystitis. They have a bactericidal effect on most of these pathological pathogens. At the same time, bacterial resistance to nitrofuran remains at a low level. Disadvantages of this group of antimicrobial agents include frequent 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 a bactericidal effect on many types of bacteria. When used internally, they quickly enter the bloodstream and begin to act 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 the age of 18, pregnant and lactating 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 phosphonic and nitrofuran antibiotics are ineffective, as well as in complicated forms of cystitis.
Fluoroquinolones should be taken 2 times 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 antibacterial effects. Today, there are 5 generations of this drug, 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 its use is the presence of hypersensitivity to beta-lactams in the patient (various allergic reactions develop). This allows the use of cephalosporins in small 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 2 times a day for adults. Dosage for children depends on their age and weight.
Tetracycline
This group of drugs belongs to synthetic antibiotics. Tetracyclines have a bacteriostatic effect, that is, they inhibit the proliferation of microorganisms. They are used today to treat cystitis when standard therapy with phosphonic antibiotics and nitrofurans has proven ineffective.
Among the disadvantages of tetracyclines, side effects are often mentioned: nephrotoxicity, dyspepsia, increased intracranial pressure, dizziness, inhibition of hematopoiesis, toxic hepatitis and others. Also, drugs in this group interfere with the formation of bone tissue, so they should not be prescribed to children, pregnant and lactating mothers.
Take 0. 1 g once or twice a day. It is recommended to monitor kidney and liver function additionally every 3 days after taking the drug.
Penicillin
Penicillin drugs have limited use for cystitis. This is due to a decrease in effectiveness due to the development of resistance in microorganisms.
However, penicillin has high safety indicators, which allows it to be used for therapy in children and pregnant women.
Side effects often include indigestion, which disappears quickly after stopping the drug. Duration of use of penicillin for cystitis is up to 7 days.