Cystitis is a very common urological disease worldwide. In the vast majority of cases, their development is due to bacterial damage to the inner epithelium of the bladder. Therefore, antibiotics for cystitis in women are often used as the drug of choice for this pathology.
Antibiotics for acute cystitis
Before deciding which antibiotic to prescribe, an experienced doctor should carefully examine and examine the patient. To diagnose acute cystitis, it is recommended to take blood and urine tests. However, it is not always necessary to accurately determine the type of pathogen. Antibiotic therapy is initially carried out empirically, with broad-spectrum medications from the urological society's recommendations catalog being preferred. It is important to note that only a doctor has the right to prescribe antibacterial drugs and self-medication often leads to complications.
For a long time, the drug of choice was a combination of sulfonamide and a dihydrofolate reductase inhibitor. However, 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 using other antibacterial agents. First of all, they prefer:
- fluoroquinolones;
- nitrofurans;
- Medicines based on phosphonic acid.
Treatment is carried out on an outpatient basis under the supervision of a urologist. The tests are repeated a few days after the start of therapy. The minimum duration of therapy for fluoroquinols is 3 days, for nitrofurans 7 days and a phosphonic antibiotic is taken only once.
Antibiotics for chronic cystitis
If the infection reaches a chronic stage, empirical antibiotic therapy is no longer acceptable. Before prescribing antibacterial drugs, a microbiological examination of urine is mandatory. It also studies the resistance of a bacterial strain to certain therapeutic agents. This allows the attending physician to select 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 undergo a comprehensive examination of not only the genitourinary organs, but also other body systems. Particular attention is paid to possible immune disorders and chronic sources of infection in the body.
Fluoroquinolones or other reserve drugs from the list are predominantly prescribed - tetracyclines, third-generation cephalosporins, macrolides. The intake lasts at least 7 days. At the same time, it should be supplemented with various non-drug treatment methods:
- surgical intervention in the event of anatomical defects and/or the presence of chronic foci of infection;
- careful hygiene;
- selection of comfortable underwear;
- treatment of immune disorders;
- temporary abstinence from sexual contact.
Preventing 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 different schemes for taking antibacterial drugs. The most common of these is the prescription of long-term therapy in low doses during remission. Take one of the drugs from the group of fluoroquinolones (0. 2 g each), nitrofurans (0. 1 g each) or a phosphonic acid 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 medications after coitus. In some cases, if symptoms appear, the patient can repeat the treatment on their own.
However, once completed, a urine test must be carried out 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 tract and other infectious processes in the body.
Selected antibacterial drugs for cystitis
Phosphonic antibiotic
The product contains phosphonic acid and is often 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. Available in powder sachet form.
This remedy should be used once 2 hours after meals before bedtime. In this case, the contents of the bag must first be mixed with 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 you may need to take the medicine again after 24 hours.
Phosphonic acid is practically not metabolized in the patient's body and is largely excreted via the kidneys. In this case, a therapeutic concentration of the drug is achieved in the urine 4-6 hours after administration, which lasts for more than two days. In addition, the drug has a number of advantages:
- convenience of one-time use;
- low side effects when used;
- limited contraindications (severe renal failure, child under 5 years);
- The drug is approved for use during pregnancy.
Nitrofurans
Nitrofurans, together 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, the bacteria's 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;
- Sleepiness;
- toxic effect on liver and kidneys.
Take nitrofuran preparations at 100 mg three times a day. The duration of treatment is 5 to 7 days.
Fluoroquinolones
This group of antibacterial drugs is a derivative of nalidixic acid. Fluoroquinolones have bactericidal activity against a variety of 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 widespread use in urology.
Fluoroquinolones are prohibited for children under 18 and 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 have been taken primarily when phosphonic antibiotics and nitrofurans are ineffective and in complicated forms of cystitis.
Fluoroquinolones should be taken twice daily for 3 days.
However, recently these drugs are practically no longer prescribed for cystitis, since in 60% of cases bacteria have developed resistance to the fluoroquinolone group.
Cephalosporins
Cephalosporins are beta-lactam antibiotics with bactericidal effects. Today there are five 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 the patient's hypersensitivity to beta-lactams (various allergic reactions occur). 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 once a day or 0. 2 g twice a day for adults. The dosage for children depends on age and body weight.
Tetracyclines
This group of drugs belongs to the synthetic antibiotics. Tetracyclines have a bacteriostatic effect, which means they inhibit the reproduction of microorganisms. They are now used to treat cystitis when standard therapy with phosphonobiotics and nitrofurans has proven ineffective.
The disadvantages of tetracyclines often include their side effects: nephrotoxicity, dyspepsia, increased intracranial pressure, dizziness, inhibition of hematopoiesis, toxic hepatitis and others. In addition, drugs in this group disrupt the formation of bone tissue and therefore should not be prescribed to children, pregnant and nursing mothers.
Take 0. 1 g once or twice daily. It is recommended to additionally monitor kidney and liver function every 3 days after taking the drug.
Penicillins
Penicillin medications have limited use for cystitis. This is due to a decreasing effectiveness due to the development of resistance in microorganisms.
However, penicillins have high safety indicators, which allows them to be used for therapy in children and pregnant women.
Side effects often include digestive disorders, which disappear quickly after the medication is stopped. The duration of use of penicillins for cystitis is up to 7 days.