Cystitis is a very common urological disease worldwide. In the vast majority of cases, its development is based on bacterial lesions of the internal epithelium of the bladder. Therefore, antibiotics for cystitis in women are widely used as drugs of choice for this pathology.
Antibiotics for acute cystitis
Before deciding which antibiotic to prescribe, an experienced doctor must carefully study and examine the patient. To diagnose acute cystitis, it is recommended to perform 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 preference is given to broad-spectrum drugs included in the list of recommendations of the urological association. It is important to note that only a doctor has the right to prescribe an antibacterial drug, 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. But 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, they favor:
- fluoroquinolones;
- nitrofurans;
- drug based on phosphonic acid.
The treatment is carried out on an outpatient basis under the supervision of a urologist. A few days after the start of treatment, the tests are repeated. The minimum duration of treatment with fluoroquinols is 3 days, that of nitrofurans is 7 days, and a phosphonic antibiotic is taken only once.
Antibiotics for chronic cystitis
When the infection progresses to the chronic stage, empirical antibiotic therapy is unacceptable. It is mandatory to carry out a microbiological examination of urine before prescribing antibacterial drugs. It also studies the resistance of a bacterial strain to specific therapeutic agents. This allows the treating physician to select 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 undergo a comprehensive examination not only of the genitourinary organs, but also of other body systems. Particular attention is paid to possible immune disorders and foci of chronic infection in the body.
Fluoroquinolones or other reserve drugs from the list are mainly prescribed - tetracyclines, third generation cephalosporins, macrolides. Their intake lasts at least 7 days. At the same time, it must be supplemented by various non-drug treatment methods:
- surgical intervention in case of anatomical defects and/or the presence of foci of chronic infection;
- careful hygiene;
- selection of comfortable underwear;
- treatment of immune disorders;
- temporary abstinence from all sexual contact.
Prevention of 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 several treatment regimens for taking antibacterial drugs. The most common of these is the prescription of prolonged treatment at low doses during remission. Use one of the drugs from the fluoroquinolone group (0. 2 g each), nitrofurans (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 medications mentioned above after coitus. In some cases, if symptoms appear, the patient can repeat the treatment themselves.
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
Phosphonic antibiotic
The product contains phosphonic acid and is widely used to treat bacterial lower urinary tract infections. The drug has a powerful bactericidal effect against E. coli, enterococci, staphylococci, Klebsiella, Proteus and other pathogens. Available in the form of powder sachets.
This remedy should be used once 2 hours after meals before bedtime. In this case, the contents of the sachet must first be mixed in a small amount of water (about a third of a glass). A single dose for adults corresponds to 3. 0 g of the drug. In some cases you need to repeat the treatment after 24 hours.
Phosphonic acid is practically not metabolized in the patient's body and is largely excreted by the kidneys. In this case, in urine, 4-6 hours after administration, a therapeutic concentration of the drug is reached, which persists for more than two days. In addition, the drug has many advantages:
- unique convenience of use;
- low rates of side effects during use;
- limited contraindications (severe renal failure, children under 5 years old);
- The drug is approved for use during pregnancy.
Nitrofurans
Nitrofurans, combined with a phosphonic antibiotic, are the drugs of choice in cases 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 low. 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, 100 mg. The duration of treatment is 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 begin to work within an hour. They are excreted from the body through the kidneys, which explains their widespread use in urology.
The use of fluoroquinolones is prohibited for children under 18 years of age, pregnant and lactating women. 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 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 no longer 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. There are now 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 resistance of microorganisms. The third generation drug is prescribed 0. 4 g 1 time or 0. 2 g 2 times a day for adults. The dosage for children depends on their age and weight.
Tetracyclines
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 treatment 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 in this group disrupt the formation of bone tissue and therefore should not be prescribed to children, pregnant and lactating women.
Take 0. 1 g once or twice a day. It is recommended to additionally monitor kidney and liver function every 3 days after taking the drug.
Penicillins
Penicillin medications have limited usefulness for cystitis. This is due to a decrease in effectiveness due to the development of resistance in microorganisms.
However, penicillins have high safety indicators, which allows them to be used for therapeutic purposes in children and pregnant women.
Side effects often include digestive upset, which disappears quickly after stopping treatment. The duration of use of penicillins for cystitis is up to 7 days.