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 the 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. Blood and urine tests are recommended to diagnose acute cystitis. But it is not always necessary to precisely determine the type of pathogen. Antibiotic therapy is first carried out empirically, and preference 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 drug, and self-medication often leads to complications.
For a long time, the drug of choice was a combination of sulfonamides and dihydrofolate reductase inhibitors. But the long-term use of this drug led to an increase in the resistance of microorganisms to it and a decrease in the effectiveness of the therapy. Therefore, modern European recommendations recommend the use of other antibacterial agents. Above all, they give priority to:
- fluoroquinolones;
- nitrofurans;
- a drug based on phosphonic acid.
Treatment is carried out on an outpatient basis under the supervision of a urologist. A few days after the start of therapy, the tests are repeated. The minimum duration of therapy for fluoroquinols is 3 days, nitrofurans - 7 days, and the phosphonic antibiotic is taken only once.
Antibiotics for chronic cystitis
When the infection progresses to a chronic phase, empiric antibiotic therapy is unacceptable. Before prescribing antibacterial drugs, it is mandatory to perform a microbiological examination of the urine. It also studies the resistance of a bacterial strain to specific therapeutic agents. This allows the doctor 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 - tetracyclines, third-generation cephalosporins, macrolides - are mostly prescribed. The course of their intake lasts at least 7 days. At the same time, it should be supplemented with various non-drug treatment methods:
- surgical intervention due to 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 contact.
Prevention of recurrence of 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 last 6 months.
There are several regimens for taking antibacterial drugs. The most common of them is prescribing a long course of therapy in low doses during remission. Use one of the drugs from the fluoroquinolone group (0. 2 g each), nitrofuran (0. 1 g each) or a phosphonic 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 medicines after coitus. In some cases, if symptoms appear, the patient can repeat the course of treatment himself.
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 in the absence of abnormalities in the development of the urinary tract and other infectious processes in the body.
Selected antibacterial drugs for cystitis
A 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 on E. coli, enterococci, staphylococci, Klebsiella, Proteus and other pathogens. Available as 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, it is necessary to repeat the application of the drug 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 lasts longer than two days. In addition, the drug has a number of advantages:
- convenience of single use;
- low rates of side effects when used;
- limited contraindications (severe kidney failure, children under 5 years of age);
- the drug is approved for use during pregnancy.
Nitrofurans
Nitrofurans, along with a phosphonic 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 at 100 mg. The duration of the treatment is from 5 to 7 days.
Fluoroquinolones
This group of antibacterial drugs is a derivative of nalidixic acid. Fluoroquinolones have a bactericidal effect against a wide range of bacteria. When used internally, they quickly enter the bloodstream and start working within an hour. They are excreted from the body through the kidneys, which explains their wide application in urology.
Fluoroquinolones are prohibited for use in children under 18, pregnant and lactating women. This is due to their negative influence 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 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 in 60% of cases bacteria have developed resistance to the group of fluoroquinolones.
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 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 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 drug of the third generation 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. Today, they are 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, etc. Also, drugs from this group disturb the formation of bone tissue, so they should not be prescribed to children, pregnant and lactating women.
Take 0. 1 g once or twice a day. Additional monitoring of kidney and liver function is recommended every 3 days of 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 of microorganisms.
However, penicillins have high safety indicators, which allows them to be used in therapy in children and pregnant women.
Side effects often include digestive disturbances, which disappear quickly after stopping the drug. Duration of use of penicillin for cystitis is up to 7 days.