Antimicrobials for the genitourinary system. Tablets for urinary tract and kidney infections. What diseases are antibiotics used for?

Infectious and inflammatory diseases of the urinary tract include urethritis, cystitis, ureteritis and pyelitis. At the heart of the occurrence of all these diseases is the penetration of pathogenic microorganisms and the activation of opportunistic flora in the urinary tract. A urinary tract infection develops because the body's own immune forces cannot cope with the bacteria that have entered.

Therefore, it is necessary to treat urinary tract infections with the obligatory use of antibacterial drugs.

Most often, the genitourinary tract affects such bacteria: E. coli, chlamydia, Pseudomonas aeruginosa, mycoplasmas and streptococci.

90% of all infections are associated with E. coli entering the urethra. And pathogens such as chlamydia and mycoplasma, in addition to the urinary tract, also affect the genitals. Many sexually transmitted diseases are accompanied by inflammation of the urinary tract. In this case, therapy is based on the elimination of the underlying disease.

What groups of antibiotics can cope with the disease

The choice of antibiotics depends on the pathogen. In addition, many drugs have a toxic effect on the kidney tissue. Therefore, they are not used in the treatment of urinary tract infections. Since it takes time to determine the pathogen and its sensitivity to antibiotics, the selection of the drug is based on the use of broad-spectrum antibiotics. After all, the sooner treatment begins, the easier it is to get rid of the disease.

Treatment of urinary tract infections is carried out with cephalosporins, macrolides, fluoroquinolones, sulfanilamide, nitrofuran drugs and pipemidic acid:

• Cephalosporins (Ceftriaxone, Cefuroxime) are broad-spectrum antibacterial drugs that effectively destroy almost all groups of pathogenic bacteria in the organs of the urinary tract.
• Macrolides, in addition to the antimicrobial effect, have a moderate anti-inflammatory and immunomodulatory effect. Their use is accompanied by a low risk of side effects. However, these drugs for urinary tract infections are not primarily used and should be prescribed by a doctor.
• Sulfanilamide preparations are also highly effective in bacterial inflammation. Due to the fact that some people unreasonably use them for the slightest cold, bacteria develop resistance and the drug is ineffective. However, people who do not abuse self-medication, when using them, quickly cope with the disease. Contraindication to their appointment - renal failure.
• Nitrofuran preparations (Furazolidone, Furadonin) are often used in older people with chronic, indolent diseases of the urinary tract. Contraindication to their use is renal failure.
• Antibacterial drugs pipemidic acid are used in men with urinary tract infections against the background of prostate adenoma. These drugs include Palin, Pimidel and Urotractin.

Absolutely all medicines have their own indications and contraindications. You should not choose the drug yourself. Questions of how and what to treat pathology should be handled exclusively by a doctor. In addition, each person shows different doses and courses of administration. On average, antibiotics are prescribed for 10-14 days.

Early cancellation of this type of treatment or even refusal to use antibiotics leads to the development of latent, chronic inflammation, which is more difficult to treat than an acute process.

The abolition of antibiotics is carried out when there are no bacteria and signs of inflammation in the urine test. Otherwise, if the antibiotic is removed, the remaining bacteria develop sensitivity to the previously used drug. And then, during an exacerbation, you will have to prescribe a stronger drug that can cope with the infection.

The use of herbal uroseptics in the treatment of urinary tract infections

Auxiliary treatment for urinary tract infections is carried out using herbal uroseptics. Also, these drugs are indicated for prophylactic use in patients with chronic infectious and inflammatory diseases of the urinary system.

Herbal preparations disinfect urine, promote the removal of pathological agents from the urinary tract and improve the function of the organs of the urinary system.

Plant-based uroseptics come in the form of tablets or drops. They are taken in long courses as prescribed by the attending physician. The most common drugs in use are Kanefron, Urolezin, Urolesan, Fitolizin.

Symptomatic therapy for urinary tract infections

Infection of the bladder, urethra, urinary canal and pyelocaliceal system of the kidneys is manifested by the following symptoms:

• Discomfort and burning when urinating
• Frequent urination in small portions, up to the appearance of urges every 10-15 minutes
• The appearance in the urine of pathological impurities (mucus, pus, blood)
• Increased frequency of nighttime urination
• Slight rise in temperature
• Pain in the lumbar and suprapubic region.

Symptomatic treatment of urinary tract infection is used to eliminate all the above clinical manifestations. Depending on the expressed symptoms, one or more of these drugs are prescribed:

• Painkillers that do not have nephrotoxicity
• Diuretics to increase urine output and prevent fluid accumulation in the urinary tract
• Antispasmodics also have an analgesic effect and prevent urinary retention.

It should be noted that taking the above medications without medical prescription is not safe. Because there are various forms of the disease for which this or that drug is a contraindication. For example, with cervical cystitis, urinary retention is observed due to spasm of the sphincter. And the use of a diuretic drug will lead to an even greater accumulation of fluid in the bladder and an increase in pain.

What drugs are taken to increase immunity

Normally, immune reactivity is provided by special cells - macrophages. In order to quickly get rid of the urinary tract infection and prevent recurrence, immune correction should be carried out.

Patients are prescribed multivitamin preparations in tablets. You can use a complex of vitamins and minerals. And you should not choose the most expensive drug - after all, expensive does not mean high quality. Many domestic drugs have the same properties as expensive imported multivitamins.

In addition to vitamin therapy, immunomodulatory treatment can be used.

However, if vitamins do not harm anyone, then the appointment of an immunomodulatory drug should be taken more seriously and in no case should you take the drug without consulting a doctor.

Treatment of the disease with folk methods

Non-medical treatment of the disease is carried out using various herbal baths, teas, juices, etc. The following methods can be noted, which, according to reviews, have good efficiency:

• Cranberry juice can inhibit the growth of bacteria and prevent them from attaching to the walls of the urinary tract. It improves the excretion of pathogenic microorganisms in the urine. It is recommended to drink a glass of cranberry juice a day. It should be noted that many other juices, in particular citrus fruits, are contraindicated in urinary infections.
• Echinacea boosts the immune system. Taking tea from echinacea, the patient simultaneously increases the amount of fluid entering the body. And with genitourinary diseases, drinking plenty of water is very important. Drink 3 cups of echinacea root tea per day.
• Milk thistle also has a number of positive effects. This plant is a storehouse of vitamins A, B, C, E, K and many others. The use of milk thistle increases the body's immune reactivity and promotes rapid recovery. And in chronic cystitis, the use of this plant helps to prevent the recurrence of pathology.
• Bearberry has an antiseptic effect, but is contraindicated for long-term use. It is recommended to use an extract from the leaves of this plant for the duration of the symptoms of the disease. In addition, bearberry should not be drunk simultaneously with vitamin C, since there will be no effect from such treatment.
• To alkalize the environment in the bladder, urethra and ureters, it is recommended to drink a soda drink at the first signs of the disease. To do this, dissolve a quarter teaspoon of soda in half a glass of water. Before using it, drink 2 glasses of plain water. The alkaline environment does not irritate the bladder, which helps reduce inflammation.

Treatment only by folk methods will not bring the desired effect. It must be remembered that a genitourinary infection will go away without a trace only after the use of antibiotics.

The video talks about the benefits of cranberries:

How to prevent the transition of acute pathology into chronic

In order to get rid of genitourinary infections once and for all, the following recommendations should be followed:

• Strictly adhere to medical prescriptions and do not self-medicate
• Do not stop the drug on your own
• The acute period of the disease is best spent in bed
• Maintain urinary hygiene
• Avoid sexual intercourse during treatment
• Follow a diet with the exclusion of extractive, irritating substances
• Drink plenty of fluids, preferably in the form of warm compotes
• Avoid alcohol, coffee and carbonated drinks
• Avoid hypothermia.

Observing simple rules and strictly following the instructions of the doctor, the patient will safely get rid of the pathology and return to the usual rhythm of life.

Pyelonephritis, cystitis and other diseases of the urination system require complex therapy. Antibiotics are an effective remedy for infections of the genitourinary system, but they should be used only as directed by a doctor. Only by passing tests can you determine the pathogen that led to the disease and determine an effective medicine.

If you have a urinary tract infection, you may need to take several types of medications for a full recovery.

Indications for treatment

The genitourinary system and kidneys during inflammation and infection with harmful bacteria are determined by specific symptoms. Diseases are accompanied by pain, burning and frequent urination. The patient, when diagnosing genitourinary infections, cannot have a normal sexual life. Without the use of properly selected drugs, inflammation of the urinary tract leads to complications. Drug therapy is prescribed for such diseases:

• pyelonephritis;
• cystitis;
• urethritis in men;
• vaginitis in women;
• chlamydia.

Some types of pathogenic microorganisms are sexually transmitted. Timely diagnosis will help to avoid negative consequences.

Types of drugs for the genitourinary system

In kidney diseases, taking into account the etiology of the disease, various groups of drugs are used to combat pathologies. Depending on the active substances that make up the drugs, they affect the body in different ways. The main types of medicines that are used to treat infections of the genitourinary system:

Antibiotics, uroseptics, NSAIDs, immunomodulators and other medicines are taken from urinary tract infections.

• NSAIDs;
• uroseptics;
• drugs for symptomatic treatment;
• immunomodulators.

Antibiotics

And urinary tract infections are prescribed depending on the pathogen. But it takes time to determine it, therefore, as a rule, therapy begins with broad-spectrum antibiotics. Treatment with such drugs helps to get rid of the problem in a short time, but requires an integrated approach. After a course of taking such funds, attention should be paid to the restoration of beneficial microflora.

Drug groups

To cure inflammation of the genitourinary system, the following types of antibacterial agents are used:

• Nitrofuran drugs - prescribed to fight infection in the elderly. Do not use in renal failure.
• Cephalosporins - effectively destroy almost all types of pathogenic microorganisms of the genitourinary system.
• Macrolides have immunomodulatory and anti-inflammatory effects. But they are used only as directed by a doctor.
• Sulfonamides - successfully fight bacterial inflammation. Do not use for kidney problems.
• Antibacterial agents based on pipemidic acid are used to fight infection in men caused by prostate adenoma.

Anti-inflammatory drugs

A group of drugs that can quickly relieve pain and inflammation of the bladder. Contribute to the restoration of normal blood circulation and the cessation of spasms. Means based on "Ibuprofen" quickly help to return to a normal way of life, alleviate the symptoms of the disease. When diagnosing gastrointestinal problems, do not use pills. An anti-inflammatory agent is administered intramuscularly or rectal suppositories are used to prevent stomach disorders.

uroseptics

Medicines of this group have antimicrobial and antiseptic effects. They are based on herbs and, as a rule, are used for the prevention of diseases in people with chronic infectious diseases of the urinary system. The action of the funds is aimed at improving the functions of the genitourinary organs, disinfect urine and promote the elimination of harmful substances in a natural way.

Symptomatic drugs

A urinary tract infection is accompanied by the following symptoms:

• pain in the lower back or in the suprapubic area;
• burning when urinating;
• frequent urge to go to the toilet, every 10-15 minutes;
• the appearance in the urine of pus, blood or mucus;
• temperature rise.

To get rid of these symptoms with inflammation of the kidneys, doctors prescribe symptomatic therapy with antispasmodics, diuretics, or analgesics. The former prevent urinary retention and relieve pain. Diuretics increase the amount of urine. In turn, painkillers should not be nephrotoxic. Otherwise, acute renal failure develops. In addition, while taking a course of antibiotics, it would be useful to use prebiotic preparations to restore the functioning of the gastrointestinal tract and restore beneficial microflora.

Urinary tract infection (UTI) - the growth of microorganisms in various parts of the kidneys and urinary tract (MT), which can cause an inflammatory process, localization corresponding to the disease (pyelonephritis, cystitis, urethritis, etc.).

Children's UTI occurs in Russia with a frequency of about 1000 cases per 100,000 population. Quite often, UTIs tend to be chronic, recurrent. This is due to the peculiarity of the structure, blood circulation, innervation of the MP and age-related dysfunction of the immune system of the growing child's body. In this regard, it is customary to single out a number of factors contributing to the development of UTI:

• violation of urodynamics;
• neurogenic bladder dysfunction;
• the severity of the pathogenic properties of microorganisms (adhesion, release of urease);
• features of the patient's immune response (decrease in cell-mediated immunity, insufficient production of antibodies to the pathogen, production of autoantibodies);
• functional and organic disorders of the distal colon (constipation, imbalance of intestinal microflora).

In childhood, UTIs in 80% of cases develop against the background of congenital anomalies of the upper and lower urinary tract, in which there are violations of urodynamics. In such cases, they speak of a complicated UTI. With an uncomplicated form of anatomical disorders and disorders, urodynamics is not determined.

Among the most common malformations of the urinary tract, vesicoureteral reflux occurs in 30-40% of cases. Second place is occupied by megaureter, neurogenic dysfunction of the bladder. With hydronephrosis, infection of the kidney occurs less frequently.

Diagnosis of UTI is based on many principles. It must be remembered that the symptoms of UTIs depend on the age of the child. For example, newborns have no specific symptoms of a UTI and the infection rarely generalizes.

Young children are characterized by symptoms such as lethargy, restlessness, occasional fevers, anorexia, vomiting, and jaundice.

Older children are characterized by fever, back pain, abdominal pain and dysuria.

The list of questions in the collection of anamnesis includes the following items:

• heredity;
• complaints during urination (increased frequency, pain);
• previous episodes of infection;
• unexplained rises in temperature;
• the presence of thirst;
• the amount of urine excreted;
• in detail: straining during urination, diameter and intermittency of the jet, imperative urge, urination rhythm, urinary incontinence during the day, nocturnal enuresis, frequency of bowel movements.

The doctor should always strive to more accurately establish the localization of a possible focus of infection: the type of treatment and the prognosis of the disease depend on this. To clarify the topic of lesions of the urinary tract, it is necessary to have a good knowledge of the clinical symptoms of infections of the lower and upper urinary tract. In case of upper urinary tract infection, pyelonephritis is significant, which accounts for up to 60% of all cases of hospitalization of children in a hospital ( ).

However, the basis for the diagnosis of UTIs is urinalysis data, in which microbiological methods are of primary importance. Isolation of the microorganism in the urine culture serves as the basis for the diagnosis. There are several ways to collect urine:

• fence from the middle portion of the jet;
• urine collection in the urinal (in 10% of healthy children up to 50,000 CFU / ml, at 100,000 CFU / ml, the analysis should be repeated);
• catheterization through the urethra;
• suprapubic aspiration (not used in Russia).

A common indirect method for assessing bacteriuria is a nitrite test (nitrates normally found in urine are converted to nitrites when bacteria are present). The diagnostic value of this method reaches 99%, but in young children, due to the short stay of urine in the bladder, it is significantly reduced and reaches 30-50%. It must be remembered that in young boys there may be a false positive result due to the accumulation of nitrites in the preputial sac.

Most UTIs are caused by one type of microorganism. The determination of several types of bacteria in samples is most often explained by violations of the technique for collecting and transporting the material.

In the chronic course of UTI, in some cases, it is possible to identify microbial associations.

Other methods of urinalysis include the collection of a general urine test, the Nechiporenko and Addis-Kakovsky test. Leukocyturia is observed in all cases of UTI, but it must be remembered that it can be, for example, with vulvitis. Gross hematuria occurs in 20-25% of children with cystitis. In the presence of symptoms of infection, proteinuria confirms the diagnosis of pyelonephritis.

Instrumental examinations are carried out for children during the remission of the process. Their purpose is to clarify the localization of the infection, the cause and extent of kidney damage. Examination of children with UTI today includes:

• ultrasound scanning;
• voiding cystography;
• cystoscopy;
• excretory urography (obstruction in girls - 2%, in boys - 10%);
• radioisotope renography;
• nephroscintigraphy with DMSA (the scar is formed within 1-2 years);
• urodynamic studies.

Conducting instrumental and x-ray examination should be performed according to the following indications:

• pyelonephritis;
• bacteriuria under the age of 1 year;
• increase in blood pressure;
• palpable mass in the abdomen;
• spinal anomalies;
• decrease in the function of concentrating urine;
• asymptomatic bacteriuria;
• relapses of cystitis in boys.

The bacterial etiology of UTI in urological diseases has distinctive features depending on the severity of the process, the frequency of complicated forms, the age of the patient and the state of his immune status, the conditions for the onset of infection (outpatient or inpatient).

The results of studies (data from the SCCH RAMS, 2005) show that in outpatients with UTIs in 50% of cases, E. coli, at 10 o'clock% - Proteus spp., in 13% - Klebsiella spp., at 3% - Enterobacter spp., in 2% - Morganella morg. and with a frequency of 11% - Enterococcus fac. ( ). Other microorganisms that accounted for 7% of the recovery and occurred at a frequency of less than 1% were as follows: S. epidermidis — 0,8%, S. pneumoniae — 0,6%, Acinetobacter spp. — 0,6%, Citrobacter spp. — 0,3%, S. pyogenes — 0,3%, Serratia spp. — 0,3%.

In the structure of nosocomial infections, UTIs take the second place, after respiratory tract infections. It should be noted that 5% of children in the urological hospital develop infectious complications due to surgical or diagnostic intervention.

In inpatients, the etiological significance of E. coli is significantly reduced (up to 29%) due to the increase and / or addition of such "problem" pathogens as Pseudomonas aeruginosa (29%), Enterococcus faec.(4%), coagulase-negative staphylococci (2.6%), non-fermentative gram-negative bacteria ( Acinetobacter spp. — 1,6%, Stenotrophomonas maltophilia- 1.2%), etc. The sensitivity of these pathogens to antibacterial drugs is often unpredictable, as it depends on a number of factors, including the characteristics of nosocomial strains circulating in a given hospital.

There is no doubt that the main tasks in the treatment of patients with UTIs are the elimination or reduction of the inflammatory process in the renal tissue and urinary tract, while the success of treatment is largely determined by rational antimicrobial therapy.

Naturally, when choosing a drug, the urologist is primarily guided by information about the causative agent of the infection and the spectrum of the antimicrobial action of the drug. An antibiotic can be safe, capable of creating high concentrations in the kidney parenchyma and urine, but if there is no activity against a specific pathogen in its spectrum, the appointment of such a drug is pointless.

A global problem in the appointment of antibacterial drugs is the growth of resistance of microorganisms to them. And most often resistance develops in out-of-hospital and nosocomial patients. Those microorganisms that are not included in the antibacterial spectrum of any antibiotic, of course, are considered resistant. Acquired resistance means that a microorganism initially sensitive to a particular antibiotic becomes resistant to its action.

In practice, people often err on the side of acquired resistance, believing that its occurrence is inevitable. But science has facts that refute such an opinion. The clinical significance of these facts is that antibiotics that do not cause resistance can be used without fear of its subsequent development. But if the development of resistance is potentially possible, then it appears quite quickly. Another misconception is that the development of resistance is associated with the use of antibiotics in high volumes. The examples of the most commonly prescribed antibiotic in the world, ceftriaxone, as well as cefoxitin and cefuroxime, support the concept that the use of antibiotics with a low potential for resistance in any amount will not lead to an increase in the future.

Many believe that for some classes of antibiotics, the occurrence of antibiotic resistance is characteristic (this opinion applies to third-generation cephalosporins), while for others it is not. However, the development of resistance is not associated with the class of antibiotic, but with a specific drug.

If an antibiotic has the potential to develop resistance, signs of resistance to it appear already during the first 2 years of use or even at the stage of clinical trials. Based on this, we can confidently predict resistance problems: among aminoglycosides, this is gentamicin, among second-generation cephalosporins, cefamandol, third-generation ceftazidime, among fluoroquinolones, trovofloxacin, and among carbapenems, imipenem. The introduction of imipenem into practice was accompanied by the rapid development of resistance to it in P. aeruginosa strains, and this process continues now (the appearance of meropenem was not associated with such a problem, and it can be argued that it will not arise in the near future). Among the glycopeptides is vancomycin.

As already mentioned, 5% of patients in the hospital develop infectious complications. Hence the severity of the condition, and the increase in the terms of recovery, stay in bed, and the increase in the cost of treatment. In the structure of nosocomial infections, UTIs occupy the first place, and surgical ones (wound infections of the skin and soft tissues, abdominal ones) take the second place.

The complexity of the treatment of hospital infections due to the severity of the patient's condition. Often there is an association of pathogens (two or more, with a wound or catheter-associated infection). Also of great importance is the increased resistance of microorganisms in recent years to traditional antibacterial drugs (to penicillins, cephalosporins, aminoglycosides) used for infections of the genitourinary system.

To date, the sensitivity of hospital strains of Enterobacter spp. to Amoxiclav (amoxicillin + clavulanic acid) is 40%, to cefuroxime - 30%, to gentamicin - 50%, the sensitivity of S. aureus to oxacillin is 67%, to lincomycin - 56%, to ciprofloxacin - 50%, to gentamicin - 50 %. The sensitivity of P. aeruginosa strains to ceftazidime in different departments does not exceed 80%, to gentamicin - 50%.

There are two potential approaches to overcome antibiotic resistance. The first is to prevent resistance, for example by limiting the use of antibiotics that have a high potential for developing it; Equally important are effective epidemiological control programs to prevent the spread of hospital-acquired infections caused by highly resistant microorganisms (hospital monitoring) in a healthcare facility. The second approach is to eliminate or correct existing problems. For example, if resistant strains are common in the intensive care unit (or in the hospital in general) P. aeruginosa or Enterobacter spp., then a complete replacement in the formularies of antibiotics with a high potential for the development of resistance to antibiotics-"cleaners" (amikacin instead of gentamicin, meropenem instead of imipenem, etc.) will eliminate or minimize the antibiotic resistance of gram-negative aerobic microorganisms.

In the treatment of UTIs currently used: inhibitor-protected penicillins, cephalosporins, aminoglycosides, carbapenems, fluoroquinolones (limited in pediatrics), uroantiseptics (nitrofuran derivatives - Furagin).

Let us dwell on antibacterial drugs in the treatment of UTIs in more detail.

1. Inhibitor-protected aminopenicillins: amoxicillin + clavulanic acid (Amoxiclav, Augmentin, Flemoclav Solutab), ampicillin + sulbactam (Sulbacin, Unazine).
2. II generation cephalosporins: cefuroxime, cefaclor.
3. Fosfomycin.
4. Nitrofuran derivatives: furazolidone, furaltadone (Furazolin), nitrofural (Furacilin).

With an upper urinary tract infection.

1. Inhibitor-protected aminopenicillins: amoxicillin + clavulanic acid, ampicillin + sulbactam.
2. II generation cephalosporins: cefuroxime, cefamandol.
3. III generation cephalosporins: cefotaxime, ceftazidime, ceftriaxone.
4. IV generation cephalosporins: cefepime.
5. Aminoglycosides: netilmicin, amikacin.

With nosocomial infection.

1. III and IV generation cephalosporins - ceftazidime, cefoperazone, cefepime.
2. Ureidopenicillins: piperacillin.
3. Fluoroquinolones: as indicated.
4. Aminoglycosides: amikacin.
5. Carbapenems: imipenem, meropenem.

For perioperative antibiotic prophylaxis.

1. Inhibitor-protected aminopenicillins: amoxicillin + clavulanic acid, ticarcillin / clavulanate.
2. II and III generation cephalosporins: cefuroxime, cefotaxime, ceftriaxone, ceftazidime, cefoperazone.

For antibacterial prophylaxis during invasive manipulations: inhibitor-protected aminopenicillins - amoxicillin + clavulanic acid.

It is generally accepted that antibiotic therapy for outpatients with UTIs can be empirically based on the antibiotic susceptibility data of the main uropathogens circulating in a particular region during a given observation period and the patient's clinical status.

The strategic principle of antibiotic therapy in outpatient settings is the principle of minimum sufficiency. First line drugs are:

• inhibitor-protected aminopenicillins: amoxicillin + clavulanic acid (Amoxiclav);
• cephalosporins: oral cephalosporins II and III generations;
• derivatives of the nitrofuran series: nitrofurantoin (Furadonin), furazidin (Furagin).

It is erroneous to use ampicillin and co-trimoxazole on an outpatient basis, due to the increased resistance to them. E. coli. The appointment of 1st generation cephalosporins (cephalexin, cefradin, cefazolin) is unjustified. Derivatives of the nitrofuran series (Furagin) do not create therapeutic concentrations in the renal parenchyma, therefore they are prescribed only for cystitis. In order to reduce the growth of resistance of microorganisms, the use of III generation cephalosporins should be sharply limited and the prescription of aminoglycosides in outpatient practice should be completely excluded.

An analysis of the resistance of strains of pathogens of complicated uroinfections shows that the activity of drugs from the group of semi-synthetic penicillins and protected penicillins can be quite high against Escherichia coli and Proteus, but against Enterobacteria and Pseudomonas aeruginosa, their activity is up to 42 and 39%, respectively. Therefore, drugs in this group cannot be drugs for empirical therapy of severe purulent-inflammatory processes of the urinary organs.

The activity of cephalosporins of the 1st and 2nd generations against Enterobacter and Proteus is also very low and ranges from 15-24%, against E. coli - slightly higher, but does not exceed the activity of semi-synthetic penicillins.

The activity of cephalosporins of III and IV generations is significantly higher than that of penicillins and cephalosporins of I and II generations. The highest activity was noted against Escherichia coli — from 67% (cefoperazone) to 91% (cefepime). Against Enterobacter, the activity ranges from 51% (ceftriaxone) to 70% (cefepime), and a high activity of drugs in this group is noted against proteas (65-69%). With regard to Pseudomonas aeruginosa, the activity of this group of drugs is low (15% for ceftriaxone, 62% for cefepime). The spectrum of antibacterial activity of ceftazidime is the highest in relation to all topical gram-negative pathogens of complicated infections (from 80 to 99%). The activity of carbapenems remains high - from 84 to 100% (for imipenem).

The activity of aminoglycosides is somewhat lower, especially against enterococci, but against enterobacteria and Proteus, high activity remains in amikacin.

For this reason, antibacterial therapy for UTIs in urological patients in a hospital should be based on microbiological diagnosis of the infectious agent in each patient and its sensitivity to antibacterial drugs. Initial empiric antimicrobial therapy in urological patients can be prescribed only until the results of a bacteriological study are obtained, after which it should be changed according to the antibiotic susceptibility of the isolated microorganism.

In the use of antibiotic therapy in a hospital, a different principle should be followed - from simple to powerful (minimum use, maximum intensity). The range of used groups of antibacterial drugs is significantly expanded here:

• inhibitor-protected aminopenicillins;
• cephalosporins III and IV generations;
• aminoglycosides;
• carbapenems;
• fluoroquinolones (in severe cases and in the presence of microbiological confirmation of sensitivity to these drugs).

Important in the work of a pediatric urologist is perioperative antibiotic prophylaxis (pre-, intra- and post-operative). Of course, one should not neglect the influence of other factors that reduce the likelihood of developing an infection (reducing the length of stay in the hospital, the quality of processing of instruments, catheters, the use of closed urine diversion systems, staff training).

Basic studies show that postoperative complications are prevented if a high concentration of an antibacterial drug in the blood serum (and in tissues) is created by the beginning of the surgical intervention. In clinical practice, the optimal time for antibiotic prophylaxis is 30-60 minutes before the start of the operation (subject to intravenous administration of the antibiotic), i.e. at the beginning of anesthetic measures. A significant increase in the incidence of postoperative infections was noted if the prophylactic dose of the antibiotic was prescribed not within 1 hour before the operation. Any antibacterial drug administered after the closure of the surgical wound will not affect the likelihood of complications.

Thus, a single administration of an adequate antibacterial drug for prevention is no less effective than multiple administrations. Only with prolonged surgery (more than 3 hours) an additional dose is required. Antibiotic prophylaxis cannot last more than 24 hours, since in this case the use of an antibiotic is already considered as a therapy, and not as a prophylaxis.

An ideal antibiotic, including for perioperative prophylaxis, should be highly effective, well tolerated by patients, and have low toxicity. Its antibacterial spectrum should include the probable microflora. For patients who stay in the hospital for a long time before surgery, it is necessary to take into account the spectrum of nosocomial microorganisms, taking into account their antibiotic sensitivity.

For antibiotic prophylaxis during urological operations, it is desirable to use drugs that create a high concentration in the urine. Many antibiotics meet these requirements and can be used, such as second-generation cephalosporins and inhibitor-protected penicillins. Aminoglycosides should be reserved for patients at risk or allergic to b-lactams. III and IV generation cephalosporins, inhibitor-protected aminopenicillins and carbapenems should be used in isolated cases when the surgical site is contaminated with multidrug-resistant nosocomial microorganisms. Still, it is desirable that the appointment of these drugs was limited to the treatment of infections with severe clinical course.

There are general principles of antibiotic therapy for UTIs in children, which include the following rules.

With a febrile course of UTI, therapy should be started with a broad-spectrum parenteral antibiotic (inhibitor-protected penicillins, cephalosporins II, III generations, aminoglycosides).

It is necessary to take into account the sensitivity of the microflora of urine.

The duration of treatment for pyelonephritis is 14 days, cystitis - 7 days.

In children with vesicoureteral reflux, antimicrobial prophylaxis should be long-term.

In asymptomatic bacteriuria, antibiotic therapy is not indicated.

The concept of “rational antibiotic therapy” should include not only the correct choice of the drug, but also the choice of its administration. It is necessary to strive for sparing and at the same time the most effective methods of prescribing antibacterial drugs. When using stepwise therapy, which consists in changing the parenteral use of an antibiotic to an oral one, after normalization of the temperature, the doctor should remember the following.

• The oral route is preferable for cystitis and acute pyelonephritis in older children, in the absence of intoxication.
• The parenteral route is recommended for acute pyelonephritis with intoxication, in infancy.

Antibacterial drugs are presented below, depending on the route of their administration.

Preparations for oral treatment of UTIs.

1. Penicillins: amoxicillin + clavulanic acid.
2. Cephalosporins:

   II generation: cefuroxime;

   III generation: cefixime, ceftibuten, cefpodoxime.

Drugs for parenteral treatment of UTIs.

1. Penicillins: ampicillin/sulbactam, amoxicillin + clavulanic acid.
2. Cephalosporins:

   II generation: cefuroxime (Cefu-rabol).

   III generation: cefotaxime, ceftriaxone, ceftazidime.

   IV generation: cefepime (Maxi-pim).

Despite the availability of modern antibiotics and chemotherapeutic drugs that can quickly and effectively cope with the infection and reduce the frequency of relapses by prescribing drugs for a long period at low prophylactic doses, the treatment of recurrent UTIs is still quite a challenge. This is due to:

• growth of resistance of microorganisms, especially when using repeated courses;
• side effects of drugs;
• the ability of antibiotics to cause immunosuppression of the body;
• a decrease in compliance due to long courses of taking the drug.

As is known, up to 30% of girls have a UTI recurrence within 1 year, 50% - within 5 years. In boys under 1 year of age, relapses occur in 15-20%, over 1 year - there are fewer relapses.

List the indications for antibiotic prophylaxis.

• Absolute:

  a) vesicoureteral reflux;

  B) early age; c) frequent exacerbations of pyelonephritis (three or more per year), regardless of the presence or absence of vesicoureteral reflux.

• Relative: frequent exacerbations of cystitis.

The duration of antibiotic prophylaxis is most often determined individually. Cancellation of the drug is carried out in the absence of exacerbations during the period of prophylaxis, but if an exacerbation occurs after withdrawal, a new course is required.

Recently, a new drug for the prevention of UTI recurrence has appeared on the domestic market. This preparation is a lyophilized protein extract obtained by fractionation of the alkaline hydrolyzate of certain strains E. coli and is called Uro-Vaksom. The tests carried out confirmed its high efficiency with no pronounced side effects, which gives hope for its widespread use.

An important place in the treatment of patients with UTI is dispensary observation, which is as follows.

• Monitoring urine tests monthly.
• Functional tests for pyelonephritis annually (Zimnitsky test), creatinine level.
• Urine culture - according to indications.
• Measurement of blood pressure regularly.
• With vesicoureteral reflux - cystography and nephroscintigraphy 1 time in 1-2 years.
• Sanitation of foci of infection, prevention of constipation, correction of intestinal dysbacteriosis, regular emptying of the bladder.

Literature

S. N. Zorkin, doctor of medical sciences, professor
NTsZD RAMS, Moscow

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One of the most common reasons for visiting a urologist today are genitourinary infections, which should not be confused with STIs. The latter are sexually transmitted, while MPI are diagnosed at any age and occur for other reasons.

Bacterial damage to the organs of the excretory system is accompanied by severe discomfort - pain, burning, frequent urge to empty the bladder - and in the absence of therapy, they become chronic. The best treatment option is the use of modern antibiotics, which allow you to get rid of the pathology quickly and without complications.

Genitourinary infections include several types of inflammatory processes in the urinary system, which includes the kidneys with ureters (they form the upper sections of the urinary tract), as well as the bladder and urethra (lower sections):

• Pyelonephritis is an inflammation of the parenchyma and tubular system of the kidneys, accompanied by pain in the lower back of varying intensity and intoxication (fever, nausea, weakness, chills).
• Cystitis is an inflammatory process in the bladder, the symptoms of which are frequent urge to urinate with an accompanying feeling of incomplete emptying, sharp pain, and sometimes blood in the urine.
• Urethritis is a lesion of the urethra (the so-called urethra) by pathogens, in which purulent discharge appears in the urine, and urination becomes painful.

There can be several reasons for urinary tract infections. In addition to mechanical damage, pathology occurs against the background of hypothermia and a decrease in immunity, when conditionally pathogenic microflora is activated. In addition, infection often occurs due to poor personal hygiene, when bacteria enter the urethra from the perineum. Women get sick much more often than men at almost any age (with the exception of the elderly).

Antibiotics in the treatment of MPI

In the vast majority of cases, the infection is bacterial in nature. The most common pathogen is a representative of enterobacteria - Escherichia coli, which is detected in 95% of patients. Less common are S.saprophyticus, Proteus, Klebsiella, entero- and streptococci. Thus, even before laboratory tests, the best option would be antibiotic treatment for infections of the genitourinary system.

Modern antibacterial drugs are divided into several groups, each of which has a specific mechanism of bactericidal or bacteriostatic action. Some drugs are characterized by a narrow spectrum of antimicrobial activity, that is, they have a detrimental effect on a limited number of varieties of bacteria, while others (broad spectrum) are designed to combat different types of pathogens. It is the antibiotics of the second group that are used to treat urinary tract infections.

Penicillins

The first ABPs discovered by man were almost universal means of antibiotic therapy for quite a long time. However, over time, pathogenic microorganisms mutated and created specific defense systems, which required the improvement of medications. At the moment, natural penicillins have lost their clinical significance, and instead of them, semi-synthetic, combined and inhibitor-protected antibiotics of the penicillin series are used. Genitourinary infections are treated with the following drugs of this series:

• Ampicillin. Semi-synthetic drug for oral and parenteral use, acting bactericidal by blocking the biosynthesis of the cell wall. It is characterized by rather high bioavailability and low toxicity. It is especially active against Proteus, Klebsiella and Escherichia coli. In order to increase resistance to beta-lactamases, the combined agent Ampicillin / Sulbactam is also prescribed.
• Amoxicillin. In terms of the spectrum of antimicrobial action and effectiveness, it is similar to the previous ABP, but it is distinguished by increased acid resistance (it does not break down in an acidic gastric environment). Its analogues Flemoxin Solutab and Hiconcil are also used, as well as combined antibiotics for the treatment of the genitourinary system (with clavulanic acid) - Amoxicillin / Clavulanate, Augmentin, Amoxiclav, Flemoklav Solutab.

For example, the sensitivity of Escherichia coli is slightly more than 60%, which indicates the low effectiveness of antibiotic therapy and the need to use other groups of antibiotics. For the same reason, the antibiotic sulfanilamide Co-trimoxazole (Biseptol) is practically not used in urological practice.

Cephalosporins

Another group of beta-lactams with a similar effect, differing from penicillins in increased resistance to the destructive effects of enzymes produced by pathogenic flora. There are several generations of these medications, and most of them are intended for parenteral administration. From this series, the following antibiotics are used to treat the genitourinary system in men and women:

• Cephalexin. An effective medicine for inflammation of all organs of the urogenital area for oral administration with a minimum list of contraindications.
• Cefaclor (Ceclor, Alfacet, Taracef). It belongs to the second generation of cephalosporins and is also used orally.
• Cefuroxime and its analogues Zinacef and Zinnat. Available in several dosage forms. They can be prescribed even to children of the first months of life due to low toxicity.
• Ceftriaxone. Sold in the form of a powder for the preparation of a solution, which is administered parenterally. Substitutes are Lendacin and Rocephin.
• Cefoperazone (Cefobide). A representative of the third generation of cephalosporins, which is administered intravenously or intramuscularly for genitourinary infections.
• Cefepime (Maxipim). The fourth generation of antibiotics of this group for parenteral use.

These drugs are widely used in urology, but some of them are contraindicated for pregnant and lactating women.

Fluoroquinolones

The most effective antibiotics to date for genitourinary infections in men and women. These are powerful synthetic drugs of bactericidal action (death of microorganisms occurs due to disruption of DNA synthesis and destruction of the cell wall). Due to toxicity and permeability of the placental barrier, children, pregnant and lactating women are not prescribed.

• Ciprofloxacin. Taken orally or parenterally, it is well absorbed and quickly eliminates painful symptoms. It has several analogues, including Tsiprobay and Tsiprinol.
• Ofloxacin (Ofloxin, Tarivid). The antibiotic fluoroquinolone is widely used not only in urological practice due to its effectiveness and wide spectrum of antimicrobial activity.
• Norfloxacin (Nolicin). Another drug for oral, as well as intravenous and intramuscular use. It has the same indications and contraindications.
• Pefloxacin (Abactal). Also effective against most aerobic pathogens, taken parenterally and orally.

These antibiotics are also shown in mycoplasma, since they act on intracellular microorganisms better than the previously widely used tetracyclines. A characteristic feature of fluoroquinolones is a negative effect on connective tissue. It is for this reason that drugs are forbidden to be used before reaching the age of 18, during periods of pregnancy and breastfeeding, as well as to persons diagnosed with tendonitis.

Aminoglycosides

A class of antibacterial agents intended for parenteral administration. The bactericidal effect is achieved by inhibiting the synthesis of proteins, mainly gram-negative anaerobes. At the same time, the drugs of this group are characterized by rather high rates of nephro- and ototoxicity, which limits the scope of their application.

• Gentamicin. A drug of the second generation of aminoglycoside antibiotics, which is poorly adsorbed in the gastrointestinal tract and therefore is administered intravenously and intramuscularly.
• Netilmecin (Netromycin). Belongs to the same generation, has a similar effect and a list of contraindications.
• Amikacin. Another aminoglycoside, effective for urinary tract infections, especially complicated ones.

Due to the long half-life, these drugs are used only once a day. They are prescribed for children from an early age, but lactating women and pregnant women are contraindicated. Antibiotics-aminoglycosides of the first generation in the treatment of urinary tract infections are no longer used.

Nitrofurans

Broad-spectrum antibiotics for infections of the genitourinary system with a bacteriostatic effect, which manifests itself in relation to both gram-positive and gram-negative microflora. At the same time, resistance in pathogens is practically not formed. These drugs are intended for oral use, and food only increases their bioavailability. For the treatment of urinary tract infections, Nitrofurantoin (trade name Furadonin) is used, which can be given to children from the second month of life, but not to pregnant and lactating women.

The antibiotic Fosfomycin trometamol, which does not belong to any of the above groups, deserves a separate description. It is sold in pharmacies under the trade name Monural and is considered a universal antibiotic for inflammation of the genitourinary system in women. This bactericidal agent for uncomplicated forms of inflammation of the urinary tract is prescribed as a one-day course - 3 grams of fosfomycin once. Approved for use at any stage of pregnancy, practically does not give side effects, can be used in pediatrics (from 5 years old).

When and how are antibiotics used for MPI?

Normally, the urine of a healthy person is practically sterile, but the urethra also has its own microflora on the mucosa, so asymptomatic bacteriuria (the presence of pathogenic microorganisms in the urine) is diagnosed quite often. This condition does not manifest itself externally and in most cases does not require therapy. The exceptions are pregnant women, children and people with immunodeficiency.

If large colonies of E. coli are found in the urine, antibiotic treatment is necessary. In this case, the disease occurs in an acute or chronic form with severe symptoms. In addition, antibiotic therapy is prescribed with long low-dose courses to prevent relapses (when an exacerbation occurs more than twice every six months). The following are regimens for the use of antibiotics for genitourinary infections in women, men and children.

Pyelonephritis

Mild to moderate disease is treated with oral fluoroquinolones (eg, Ofloxacin 200–400 mg twice daily) or inhibitor-protected amoxicillin. Reserve drugs are cephalosporins and co-trimoxazole. Pregnant women are hospitalized with initial therapy with parenteral cephalosporins (Cefuroxime), followed by a switch to tablets - Ampicillin or Amoxicillin, including clavulanic acid. Children under 2 years of age are also placed in a hospital and receive the same antibiotics as pregnant women.

cystitis and urethritis

As a rule, cystitis and a nonspecific inflammatory process in the urethra occur simultaneously, so there is no difference in their antibiotic therapy. Uncomplicated infection in adults is usually treated for 3-5 days with fluoroquinolones (Ofloxacin, Norfloxacin and others). Reserve are Amoxicillin / Clavulanate, Furadonin or Monural. Complicated forms are treated similarly, but the course of antibiotic therapy lasts at least 1-2 weeks. For pregnant women, the drugs of choice are Amoxicillin or Monural, alternative - Nitrofurantoin. Children are prescribed a seven-day course of oral cephalosporins or Amoxicillin with potassium clavulanate. Monural or Furadonin are used as reserve funds.

Additional Information

It should be borne in mind that in men, any form of MPI is considered complicated and is treated according to the appropriate scheme. In addition, complications and severe course of the disease require mandatory hospitalization and treatment with parenteral drugs. Oral medications are usually prescribed on an outpatient basis. As for folk remedies, they do not have a special therapeutic effect and cannot be a substitute for antibiotic therapy. The use of infusions and decoctions of herbs is permissible only by agreement with the doctor as an additional treatment.

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The main drugs for the treatment of the genitourinary system are antibiotics. Before the appointment, it is necessary to pass a urine culture for sterility, and determine the reaction of microorganisms obtained from it to antibacterial drugs. Without sowing, it is better to use broad-spectrum medicines. But some differ in nephrotoxicity (toxic effects on the kidneys), for example, "Gentamicin", "Polymyxin", "Streptomycin".

Treatment of infections with antibiotics

For inflammation of the urinary tract, antibiotics of the cephalosporin group are used - "Cefalexin", "Cefaclor", "Cefepim", "Ceftriaxone". With inflammation of the kidneys, semi-synthetic penicillin is also used - "Oxacillin" and "Amoxicillin". But it is better for urogenital infections - treatment with fluoroquinolone - Ciprofloxacin, Ofloxacin and Gatifloxacin. The duration of antibiotic use for kidney disease is up to 7 days. In complex treatment, drugs with sulphenylamide are used - "Biseptol" or "Urosulfan".

Herbal uroantiseptics

"Canephron" in case of illness

In urology, herbal uroantiseptics are used both as the main healing substances and as auxiliary ones. « Kanefron is an excellent remedy for the treatment of diseases of the genitourinary system. It has anti-inflammatory and antimicrobial action, causes a diuretic effect. It is used orally in the form of drops or dragees. The composition of "Kanefron" includes rose hips, rosemary leaves, centaury and rosemary. With inflammation of the kidneys, 50 drops of the drug or 2 tablets are prescribed 3 times a day. In men, it is considered the best remedy in the treatment of urinary infections.

"Fitolysin" - a remedy for infections of the genitourinary system, facilitates the passage of stones and removes pathological agents from the urinary tract. Mint, pine, orange, sage and vanillin oils are added to the preparation. Take anti-inflammatory after meals 3 times a day, 1 tsp. half a glass of warm water. Kidney disease resolves within a month. It is made in the form of a paste to obtain a solution. The composition of "Fitolysin" - extracts:

• horsetail;
• parsley;
• birch leaves;
• rhizomes of wheatgrass;
• fenugreek;
• hernia;
• onion bulbs;
• goldenrod;
• herbs mountaineer bird.

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Medications to relieve symptoms of inflammation of the genitourinary system

Inflammation of the urinary tract begins to be treated with drugs that stop the inflammatory symptoms and restore the functionality of the urinary tract. The main medicines for the genitourinary system are Papaverine and No-shpa. Doctors recommend using antibacterial agents after a course of antispasmodics. In parallel, they are treated with tablets that do not have the property of nephrotoxicity.

For diseases of the genitourinary system, paracetamol is used. The daily dose is 4 times 650 mg. When taking paracetamol, drink plenty of water to ensure normal hemodynamics. Ibuprofen is shown instead of paracetamol. The daily dose is 4 times 1200 mg. Other drugs for relief of symptoms: Ketanov, Nimesulide, Cefekon and Baralgin. The decision in therapy with nephrotoxic drugs is justified, and therapy is prescribed only after consulting a doctor.

Antispasmodics

Antispasmodic drugs improve urine flow and relieve pain. Popular tablets are the same "Papaverine" with "No-shpa" and "Benziklan" with "Drotaverine". "No-shpa" is available in the form of tablets and solution. Dosage - no more than 240 mg per day. "No-shpu" is strictly forbidden to take with heart and liver failure. Additionally, it is allowed to take "Kanefron" - it has both antispasmodic and antiseptic effects.

Diuretics are diuretics. Treatment with diuretics should be treated with caution. They can cause kidney failure and complicate the disease. Therapy is applied only after the appointment of a doctor. The main drugs for urinary tract infections: "Diuver", "Hypothiazid", "Furomeside" and "Aldakton". Dose - 1 tablet per week. To maintain water balance in the body, calcium, potassium, saline solutions are taken in combination with diuretics, and hemosorption and hemodialysis are carried out.

Immunostimulation in diseases of women and men

With a disease in men and women of the kidneys and urinary tract, you need to drink decoctions that contain vitamins: rosehip, birch tree leaves, mountain ash, currant leaf, knotweed. Doctors also prescribe multivitamin preparations, which include a complex of trace elements with vitamins. Medicines to increase immunity in kidney diseases - Alvittil, Aerovit, Askorutin, Tetrafolevit, Milgamma. In parallel with vitamins, minerals such as selenium and zinc are taken.

Folk remedies

• Cranberry juice will help relieve inflammation of the genitourinary system. It acts as a diuretic and prevents bacteria from multiplying.
• Unrefined coconut oil is used to kill urinary tract infections. Oil is consumed in 2 tbsp. in a day. Coconut milk contains good medicinal substances, it should be drunk on an empty stomach in the morning and a glass before bedtime.
• Inflammation of the urinary tract relieves asparagus. When eating asparagus, the color of the urine darkens, which should not be scary.
• Garlic is good for kidney problems. Peel 2 cloves of garlic, crush and pour 1 glass of water, leave for 5 minutes and drink. The procedure is repeated 3 times a day until the symptoms disappear.
• Onion - antibacterial and diuretic, promotes rapid recovery of the kidneys and urinary tract. The onion is cut into 4 equal parts, 0.5 l of water is added and boiled for 20 minutes over low heat, insisted for 8 hours, filtered and drunk.
• Inflammation of the urinary tract is treated with celery. Beat the stems, add pineapple and 200 ml of chamomile infusion. The mixture is drunk in the morning on an empty stomach. Celery seed is also used. The seed is steamed in 1 cup of hot water, infused for 10 minutes and drunk 2 times a day.
• Good infusion with basil. 2 tablespoons are added to 1 glass of water. plants, insist 10 minutes. Drink 2 days 2 times a day.

In addition to the main folk remedies for the treatment of the genitourinary tract, there are delicious recipes for alternative medicine. It is recommended to drink juice from 1 banana and an apple for a week (2 times a day). Eat at least 3 pieces of watermelon per day. In addition to medicinal qualities, it also acts as a prophylactic. A berry cocktail with cherries, cherries, blueberries and a slice is recommended, which should be drunk only on an empty stomach.

Means for prevention

Often prescribed medications of the fluoroquinolone group - "Levofloxacin", "Ciprofloxacin" or "Gatifloxacin". Inflammation of the urinary tract can be prevented by herbal medicine. Herbal infusions can be taken for a long time, there are practically no side effects from them. Optimal collection of herbs - mint, goldenrod, angelica, horsetail, bearberry. Ready-made preparations - "Canephron" or "Uriklar", which have antiseptic and anti-inflammatory effects. Candles for infections of the genitourinary system in women are especially popular ("Vitaferon", "Indomethacin", "Cystitis" and "Voltaren").

Pyelonephritis, cystitis and other diseases of the urination system require complex therapy. Antibiotics are an effective remedy for infections of the genitourinary system, but they should be used only as directed by a doctor. Only by passing tests can you determine the pathogen that led to the disease and determine an effective medicine.

If you have a urinary tract infection, you may need to take several types of medications for a full recovery.

Indications for treatment

The genitourinary system and kidneys during inflammation and infection with harmful bacteria are determined by specific symptoms. Diseases are accompanied by pain, burning and frequent urination. The patient, when diagnosing genitourinary infections, cannot have a normal sexual life. Without the use of properly selected drugs, inflammation of the urinary tract leads to complications. Drug therapy is prescribed for such diseases:

• pyelonephritis;
• cystitis;
• urethritis in men;
• vaginitis in women;
• chlamydia.

Some types of pathogenic microorganisms are sexually transmitted. Timely diagnosis will help to avoid negative consequences.

Types of drugs for the genitourinary system

In kidney diseases, taking into account the etiology of the disease, various groups of drugs are used to combat pathologies. Depending on the active substances that make up the drugs, they affect the body in different ways. The main types of medicines that are used to treat infections of the genitourinary system:

Antibiotics, uroseptics, NSAIDs, immunomodulators and other medicines are taken from urinary tract infections.

• antibacterial agents;
• NSAIDs;
• uroseptics;
• drugs for symptomatic treatment;
• immunomodulators.

Antibiotics for cystitis in women, men and children are used to destroy pathogens of inflammation and to reduce the most uncomfortable symptoms of the disease.

Modern antibacterial drugs are endowed with a wide spectrum of action, which allows them to be prescribed without first determining the sensitivity of pathogens to drugs.

Drug treatment of cystitis should be started as early as possible from the onset of bladder dysfunction. The fight against infection through only herbal remedies and diet dampens the inflammatory process, but does not lead to the destruction of the pathogen.

And this is the main reason for the transition of acute cystitis to a chronic form, exacerbations in which occurs under the influence of any minor provoking factor.

Diagnosis and selection of an individual treatment plan

Acute developing cystitis does not require identification of the type of microorganism before prescribing an antibacterial course of therapy. The antibiotics used by modern medicine destroy and prevent the further development of almost all types of pathogenic pathogens of inflammation of the bladder walls.

Patients with a chronic form of cystitis, on the contrary, are shown to establish the type of pathogenic "causative agent" of the disease.

Antibiotics are selected after bakposev, urine tests, if necessary, instrumental methods of examination are prescribed. Antibacterial drugs are selected strictly on an individual basis.

In the treatment of chronic cystitis, it is possible to use two antibiotics at once, or to conduct separate courses of therapy with different antibacterial agents.

Antibiotics for cystitis are very often used simultaneously with anti-inflammatory drugs.

The appointment of drugs from different groups allows you to quickly cope with the unpleasant symptoms of the inflammatory process and prevents the development of complications.

In the chronic course of cystitis, the use of immunomodulatory drugs is indicated, this increases the overall resistance of the body.

An antibacterial course for cystitis can be one, three or seven days. Medications, and the duration of their intake should be selected by the urologist.

Groups of antibiotics

Antibiotics are divided into several groups, in the treatment of cystitis they use:

• Fluoroquinolones;
• macrolides;
• Penicillins;
• Cephalosporins;
• Aminoglycosides.

Fluoroquinolones

Antibiotics of this group are highly active antimicrobial agents endowed with a wide spectrum of action.

Fluoroquinolones have a pronounced bacteriostatic and bactericidal effect, which leads to the destruction of the membranes of pathogenic organisms and prevents their further development.

The distinctive features of fluoroquinolones include:

• High bioavailability. After ingestion, the active substances penetrate in high concentrations into almost all tissues of the body, which provides a pronounced therapeutic effect;
• Impact on most bacteria, chlamydia and mycoplasmas;
• Long half-life, which provides a prolonged effect of the drug;
• Few adverse reactions and good tolerability.

Fluoroquinolones have shown their effectiveness in the treatment of community-acquired and hospital-acquired infections of varying severity.

Preparations of this group of antibiotics are classified into four generations, these are:

• Non-fluorinated quinolones;
• Gram-negative fluoroquinolones;
• Fluoroquinolones respiratory;
• Fluoroquinolones are anti-anaerobic.

Non-fluorinated and gram-negative fluoroquinolones are highly effective in the treatment of urinary tract infections.

But drugs from this group cannot be used during pregnancy, as they are endowed with a teratogenic effect.

The use of fluoroquinols for the treatment of cystitis in breastfeeding women can cause fontanel bulging and hydrocephalus.

The fluoroquinol series of drugs is prescribed to children in exceptional cases, since antibiotics of this group slow down the growth and development of bone tissue.

In elderly patients, the use of fluoroquinolones increases the risk of tendon damage. Antibiotics of this group of the first generation are not prescribed for kidney damage.

List of antibiotics from the group Fluoroquinolones / Quinolones

Antibiotics-fluoroquinolones are mainly prescribed for the treatment of chronic and acute forms of urinary tract infections, including cystitis, pyelonephritis, pyelitis.

These drugs are effective in uncomplicated forms of prostatitis, cervicitis.

The drug can be used as a prophylactic to prevent the recurrence of a chronic infection of the urinary organs.

Some fluoroquinolones are used to treat diarrhea in travelers.

Nolicin

The main active ingredient is Norfloxacin. Nolicin is effective in the destruction of gram-negative strains of bacteria.

The drug is rapidly absorbed by the digestive tract, high concentrations of the drug are determined in the urine.

The drug is produced in tablet form, the standard dosage for the treatment of cystitis is one tablet (400 mg) twice a day. The course of treatment for uncomplicated forms of the disease is three days.

When treating patients with chronic cystitis, therapy can last up to three months.

Tablets are drunk whole, they can not be crushed. The time of taking the medicine should be planned one hour before meals or two hours after eating.

Be sure to drink more during the period of treatment with Nilicin.

Nolicin is prohibited for use in any trimester of pregnancy; when breastfeeding, the drug is treated only after a temporary cessation of natural feeding.

Analogues of Nolicin, also containing Norfloxacin, are Glurenorm, Normaks, Lokson-400, Norilet, Deprenorm, Norfacin, Sofazin, Noroxin, Norbactin, Chibroxin, Norfloxacin, Renor, Yutibid.

Norfloxacin

Similar in mechanism of action to Nolicin. In addition to tablets, the drug is available in the form of drops for the ears and eyes, they are used in the treatment of conjunctivitis, blepharitis, and otitis media.

Norfloxacin in the treatment of inflammation of the urinary tract and pyelonephritis is prescribed 400 mg (one tablet) twice a day. The course of treatment is a week. With recurrent forms of the disease, therapy can last about 12 weeks.

Norfloxacin is prohibited during pregnancy, breastfeeding and patients under the age of 18 years.

Analogues of the drug - Nolicin, Chibroxin, Norbactin, Sofazin, Yutibid, Renor, Norilet, Noroxin, Norfacin.

Ofloxacin

The drug is endowed with a wide range of effects, it acts mainly against gram-negative strains of bacterial pathogens.

It shows high efficiency in the destruction of pathogenic microorganisms resistant to most sulfonamides and antibiotics from other groups.

In addition to the treatment of urogenital inflammatory processes, Ofloxacin is successfully used to treat inflammatory and purulent diseases of the respiratory and ENT organs, soft tissues. Sometimes used as part of the complex therapy of tuberculosis.

Ofloxacin is available in tablets. For patients with cystitis and inflammation of the urinary tract, the drug is prescribed 1 tablet (0.2 grams) twice a day.

The standard course of therapy is 7-10 days, with a mild course of the disease, it can be reduced to 4 days. Ofloxacin is not taken for more than 4 weeks in a row.

Analogues - Geofloks, Zanotsin, Zofloks, Lofloks, Oflo, Ofaksin, Oflo Tad, Oflo Sandoz, Oflohexal, Ofloksatsin, Ofloksin, Floksan.

Norbaktin

Contains Norfloxacin as an active ingredient. Produced in tablet form. In addition to the treatment of chronic and acute infections of the urinary organs, it is used for bacterial lesions of the gastrointestinal tract.

Norbactin is not prescribed for pregnant women and patients with severe kidney damage. In case of infectious processes in the urinary organs, the drug should be taken at a dose of 400 mg (one tablet) twice a day for 7-10 days.

Norbactin analogues - Nolicin, Noflohexal, Norfloxacin in tablets and capsules, Yutibid.

Monural

The active ingredient of the drug is Fosfomycin, a substance that has a bactericidal effect on most gram-positive bacteria.

Monural is effective in the treatment of patients with acute and recurrent cystitis of bacterial etiology. The drug is used to prevent infections after surgery on the urinary organs.

Monural children are prescribed after reaching 5 years. For pregnant women, the drug is prescribed if the expected benefit from the use of fosfomycin outweighs the risk of a possible teratogenic effect on the fetus.

Cystitis and other inflammatory and infectious processes of the urinary system are recommended to be treated with a single dose of Monural in the amount of 3 grams. Granules are diluted with water in the amount of 1/3 cup.

Monural's analogues for the active substance are Burney in granules, Ureacid, Urofoscin, Forteraz, Fosmitsin, Fosmural, Phosphoral, Fosfotsin, Cistoral, Espa-Fotsin.

Cifran

The main active ingredient is Ciprofloxacin. Cifran shows high efficiency in the treatment of infections caused by bacteria resistant to penicillins, aminoglycosides, cephalosporins.

Available in tablet form, as a sterile solution for intravenous injection and as eye drops.

Cifran is contraindicated for use during the period of bearing a child at any time and lactation period.

In the treatment of cystitis and urinary tract infections, Cifran tablets are prescribed 250 mg every 12 hours.

The duration of treatment of uncomplicated forms of pathologies reaches 7 days, the medicine must be drunk for at least three more days after the disappearance of the main symptoms of the disease.

In severe and recurrent forms of inflammation of the lower parts of the urinary system, treatment is carried out by administering Tsifran's solution into a vein in the form of droppers.

After infusion therapy, treatment is continued with oral intake of Cifran.

Analogues in tablets - Infitsipro, Medotsiprin, Flaprox, Tsipro-Tad, Tsiprobel, Tsiprol, Tsiprobid, Tsiprovin, Tsiprohexal, Citeral, Tsitrovenot, Tsifromed, Tsifran Od, C-phlox, Tsiprov in tablets of 250 and 500 mg.

Analogues of the drug Cifran in tablets and solutions for injection - Tsiprinol (tablets, concentrate for solution for infusion, sterile solution for injection), Cipro Sandoz (tablets, ampoule solution for injection), Tsiprobay (injection solution, tablets), Tsiprobaks (tablets, solution for injection), Ciprox (injection solution), Ciproxol (concentrate for the preparation of drugs for infusion, tablets), Ciprolet (tablets, solution for injection), Cypronate (tablets, injection solution), Ciprofarm (in the form of a solution for injection), Ciprofloxacin (tablets, solution for injection, capsules), Ciprocin-N (concentrate for solution for infusion), Ciflox in solution for infusion.

Levofloxacin

The main active ingredient is levofloxacin hemihydrate. The medicine is endowed with a wide spectrum of action.

Levofloxacin destroys pathogenic microorganisms at any stage of growth and at rest, due to this, the drug is effective in the treatment of complicated and uncomplicated infections of the urogenital area, respiratory organs.

The drug is not prescribed for pregnant women, patients under 18 years of age and women in the lactation period.

Available in the form of tablets and as a solution for injection. Patients with urinary tract infections are advised to take Levofloxacin 250 mg once a day.

With uncomplicated forms of diseases, treatment lasts three days, with complicated forms, its duration increases to a week.

Analogues in tablets - Lebel, Lamin, Levobakt, Levoled, Levokilz, Levoksa, Levostad, Levoflotsin, Leflokad, Taxatsin, Flexid, Lefloks, Novoks, Potant-Sanovel, Hailefloks.

Analogues of Levofloxacin in the form of a solution of injections, infusions (intravenously) and tablets - Afibloks, Glevo, Zolev, Levaksel, Levobaks, Levox, Levoksimed, Levomak, Levotor, Levofloks, Levocep, Levocel, Levotsin, Leflok, Leflotsin, Loksof, L-Floks, Tavanic, Remedia, Tigeron, Phloxium.

Analogues only in the form of a solution for infusions (intravenously) and injections - Zevotsin, Levasept, Levinor, Levo, Unifloxin, Levogrin, Levokatsin, Levonik, Levopro, Levofast, Lefo-FK, Leflok, Lefsan,

Pefloxacin

The drug destroys most gram-negative bacteria, excluding anaerobic ones. Gram-positive strains of bacteria are destroyed when they are at the stage of division.

Pefloxacin, in addition to the treatment of the genitourinary organs, is prescribed for the treatment of genital infections, bone diseases, infections of the respiratory and digestive systems.

Pefloxacin is available in tablets and as a sterile solution for intravenous administration.

In the treatment of uncomplicated forms of inflammatory and infectious processes in the urinary organs, the recommended single dosage is 400 mg, the frequency of administration is twice a day. Antimicrobial therapy when using Pefloxacin should not exceed two weeks.

The drug is not prescribed to persons under 18 years of age, women during pregnancy and breastfeeding.

Analogues of Pefloxacin - Unikpef, Peflacin, Pelox-400, Perth, Abaktal, Pefloxabol, Peflocin.

Ciprofloxacin

The drug has a high therapeutic activity, compared with Norfloxacin, the drug is almost 8 times stronger.

When ingested, it quickly penetrates into the tissues of the kidneys, is released for a long time, which enhances the bactericidal effect of the active components.

Ciprofloxacin is highly effective in the treatment of complicated infectious and inflammatory pathologies of the urinary organs. The drug is also used in the treatment of infectious diseases in patients with cancer.

Available in tablet form and as a solution for injection.

For uncomplicated infectious diseases of the urinary tract, Ciprofloxacin is prescribed at a dosage of 0.125-0.5 grams twice a day, for complicated infections, a single dose of up to 0.75 grams. The duration of therapy is from five to 15 days.

Ciprofloxacin is not prescribed to pregnant women, adolescents under 15 years of age, breastfeeding women.

Analogues of Ciprofloxacin - Sifloks, Liprhin, Ificipro, Ceprova, Tsiprinol, Quintor, Tsiprobay, Tsiprodox, Tsiprobid, Tsifran, Tsiprolet, Microfloks, Medotsiprin, Procipro, Recipro, Afinoxin, Tsiproksol.

Lomefloxacin

The drug is active against anaerobic Gram-negative bacteria, including E. coli, Enterobacter, Salmonella. Ureplasma, streptococci, mycoplasma are not sensitive to Lomefloxacin.

Lomefloxacin is the drug of choice for rifampicin intolerance.

The medicine is available in tablets. In infectious pathologies of the urinary tract, Lomefloxacin is used in a daily dosage of 400 mg, the tablets are drunk once a day.

Uncomplicated forms of diseases are treated for three to five days, complicated ones are mostly two weeks.

The drug is prohibited for use during breastfeeding, during the period of bearing a child, until the patient reaches 18 years of age.

Analogues of Lomefloxacin - Tavanic, Levolet, Levotek, Hailefloks, Levofloxabol, Levofloks, Lomfloks, Leflobakt, Lefoktsin, Glevo, Tanflomed, Xenaquin, Flexid, Floracid, Maklevo, Elefloks, Remedia.

Sparfloxacin

The drug is endowed with a wide spectrum of antimicrobial activity. Among the side effects, phtotoxic reactions are distinguished, which manifest themselves even with a single use of Sparfloxacin.

The drug has a prolonged action, so it is taken once a day.

Produced in tablet form. In the treatment of infectious and inflammatory diseases of the urinary organs on the first day, it is necessary to take 0.2 grams of the drug, over the next 10-14 days, drink 0.1 grams every day.

The drug is contraindicated in children and adolescents under 18 years of age, pregnant and lactating women.

Complete analogue of Sparfloxacin tablets Sparfo.

Moxifloxacin

The antibiotic, belonging to the 4th generation of fluoroquinolones, is produced under the trade name Avelox.

The drug is endowed with a wide spectrum of action, bactericidal action occurs with minimal formation of toxic elements, which reduces the likelihood of severe adverse reactions.

Avelox is used for cystitis if inflammation of the bladder is accompanied by a urogenital infection. The drug has proven its effectiveness in the treatment of pyelonephritis.

Available in tablets and as an infusion solution. The standard dosage in the treatment of acute infections is 400 mg per day for 7 to 10 days.

In severe cases, treatment begins with the introduction of a solution, after which they switch to oral tablets.

Analogues of Avelox - Maxitsin, Moxetero, Moximac, Moxivar, Moxifluor, Moxin, Moflax, Moflox, Mofloxin Lupine, Gemifloxacin, Tevalox, Vigamox.

Enoxacin

The drug is endowed with antimicrobial activity against gram-positive and gram-negative anaerobic bacteria. Rapidly absorbed when taken orally.

Enoxacin is used in the treatment of urinary tract infections of unknown location.

The drug is effective in the treatment of prostatitis and gonorrhea that occurs with damage to the urethra.

Enoxacin is available in 200 mg tablets. For the treatment of diseases of the urinary tract, the drug is prescribed 200 mg in the morning and evening.

Mild forms of diseases are treated within 5 days, with complicated pathologies, the course is extended to 15 days.

During pregnancy and during lactation, Enoxacin can be used, but only under strict indications.

Fleroxacin

The drug is available in tablets and in solution for parenteral administration. The drug has a bactericidal effect on pathogenic microorganisms, which leads to the death of bacteria.

When ingested, it creates high concentrations of the active substance in the urine.

Fleroxacin is prescribed for the treatment of complicated and uncomplicated forms of urinary tract infections.

The dosage of the drug in the treatment of cystitis is 200-400 mg, taken twice a day. The duration of treatment is determined by the sensitivity of the organism to the antibiotic, but treatment should continue for at least 7 and no more than 30 days.

Fleroxacin is not used in the treatment of lactating and pregnant women.

Gatifloxacin

The drug is widely used in the treatment of infections resistant to cephalosporins, penicillins, aminoglycosides.

Gatifloxacin is effective in eliminating infections caused by chlamydia, mycoplasma, legionella.

The medicine is produced only in the form of a sterile solution for infusion administration. It is administered in the treatment of pyelonephritis and diseases of the urinary system of bacterial etiology, 400 mg once a day by drip. The course of therapy - 5-14 days

The lactation period and all trimesters of pregnancy are contraindications to the appointment.

Analogues of Gatifloxacin - Bigaflon, Gatibakt, Gati, Gatilin, Gatijem, Gatinova, Gatimak, Gatacin_n, Gatispan, Zikvin, Dasikon, Ozerlik, Tebris.

Palin

The active active ingredient of the drug is pipemidic acid. The drug is well tolerated, the most common side effects are disorders of the digestive tract.

Palin is prescribed for the treatment of acute and chronic infections of the urinary tract.

Feedback on the effectiveness of Palin treatment is mostly positive. Available in capsules.

In the treatment of inflammatory and infectious diseases of the kidneys and bladder, Palin is prescribed two capsules (400 mg) twice a day.

Pipemidic acid should be taken after meals with plenty of water.

Nevigramon

Depending on the sensitivity of the bacteria, it acts bacteriostatically or bactericidal.

Nevigramone is the only fluoroquinolone antibiotic approved for use during pregnancy in the second or third trimester.

For lactating women, the drug is allowed after the cessation of feeding. Nevigramon is prescribed for children after two years.

The drug is available in capsules. In the treatment of cystitis and other infections of the urinary organs, Nevigramone is used in a single dosage of 1 gram (2 capsules) four times a day.

With long-term treatment, a single dosage is reduced to 500 mg.

Other fluoroquinolone antibiotics used to treat infectious diseases of MPS: Levinor, Sofazin, Glevo, Abiflox, Lomflox, Medotsiprin, Novox, Remedia, Tigeron, Citeral, Hyleflox, Negram, Pimidel, Urosept, Uniclef, Faktiv, Lomaday, Zoflox, Lamin, Gatispan.

Cephalosporins

The group of cephalosporin antibiotics in medicine is used most often. The basis of cephalosporins is 7-ACA or otherwise aminocephalosporanic acid.

Compared with penicillin antibiotics, cephalosporins are endowed with greater resistance to enzymes produced by pathogenic microorganisms. Due to this, the therapeutic effect of the drugs is also enhanced.

The distinctive features of drugs from the class of cephalosporins include:

• Good tolerance and the least number of adverse reactions;
• Minimal impact on the intestinal microflora;
• Wide spectrum of therapeutic action;
• High synergy (that is, increased effect) when used simultaneously with aminoglycosides.

Tableted forms of cephalosporins are well absorbed by the digestive system, the highest concentrations of the active substance accumulate in the tissues of the kidneys, urinary tract, liver and lungs.

Based on the spectrum of effects on the body, the structure of dosage forms and their resistance to lactamases, the cephalosporin series of antibiotics is divided into five generations:

• The first generation of drugs include Cefalotin, Cephaloridin, Cefradin, Cefapirin, Cefalexin, Cefadroxil;
• The second generation includes - Cefuroxime, Cefotiam, Cefamandol, Cefaclor, Cephroxitin;
• The third generation includes Ceftriaxone, Ceftazidime, Cefodizyme, Cefoperazone, Cefotaxime, Cefdibuten;
• The fourth generation of cephalosporins - Ceftaroline, Ceftobil, Ceftolose.

Preparations from the first generation are most often prescribed in the treatment of infectious and inflammatory processes on the skin. The remaining three generations of cephalosporins are already endowed with a wider range of effects.

Cephalosporin antibiotics are also divided into agents for oral and parenteral intramuscular or intravenous administration.

List of cephalosporin antibiotics

Most cephalosporin antibiotics are successfully used to treat:

• Infectious and inflammatory diseases of the ENT organs and the respiratory tract - pharyngitis, sinusitis, otitis media, bronchitis, pneumonia;
• Infections of the genitourinary system, including cystitis and pyelonephritis;
• Genital infections;
• Inflammatory and infectious processes of articular and bone tissue;
• Purulent-inflammatory processes of the skin.

Before the appointment of cephalosporins, it is necessary to establish contraindications and the effectiveness of drugs.

Cefalexin

The drug belongs to the means of the first generation, is a semi-synthetic drug.

Cefalexin disrupts the synthesis of bacterial membranes, the antimicrobial activity is high. The antibiotic is resistant to bacterial penicillinases, but is destroyed by cephalosporinases.

Cefalexin is produced in the form of capsules and in the form of granules, for the preparation of a suspension.

The liquid form of the drug can be used in the treatment of children from 6 months, capsules are prescribed after the child reaches three years of age.

With the development of cystitis, pyelonephritis Cefalexin for adult patients is prescribed in a single dosage of 200-400 mg, take the drug four times a day.

The dosage of the suspension for children is selected based on their age. Children up to a year are prescribed 2.5 ml of the prepared suspension three or four times a day. The course of therapy with Cefalexin is from 7 to 14 days.

The drug is not approved for use by pregnant and lactating women.

Analogues of Cefalexin for the active substance - Lexin in capsules and powder for the preparation of a suspension, Ospexin in granules for a suspension.

Cefoxitin

The drug belongs to the second generation cephalosporins. The drug is endowed with a wide range of antimicrobial effects on gram-negative and part of gram-positive bacteria.

Dosage form - a powder used for the preparation of an injection solution.

Cefoxitin can be used from the neonatal period, but the drug is contraindicated during pregnancy. If treatment is necessary during the lactation period, then breastfeeding should be interrupted for a while.

Adult patients in the treatment of the lungs for the course of MPS infection Cefoxitin is administered intramuscularly twice a day, one gram.

In severe cases, the drug is prescribed for injection into a vein, 2 grams every four hours. For children, the dosage is calculated based on their weight.

Cefuroxime

The cephalosporin antibiotic Cefuroxime is a second-generation drug. The drug is endowed with broad antimicrobial activity.

Do not prescribe this drug if intolerance to penicillin antibiotics, carbapenem (a class of β-lactam antibiotics, with a wide spectrum of action) and cephalosporins of other generations is established.

Cefuroxime is prohibited during pregnancy, while breastfeeding and in patients with a pronounced decrease in immunity.

The medicine is produced in tablets and in powder for the preparation of a solution for injection.

In the treatment of infections of the urinary system, the drug is prescribed in tablets of 125 mg every 12 hours.

In the treatment of pyelonephritis, a single dosage is increased to 250 mg. Injection administration of the drug is carried out three times a day, 750 mg each.

Analogues in the form of tablets and powder for solution - Aksef, Zosef, Kimatsef, Mikres, Spizef, Cefuroxime.

Cephaloridine

Belongs to the first generation of cephalosporins. The drug is endowed with high antimicrobial activity. When taken orally, it is poorly absorbed, therefore it is used only for injection.

Cephaloridine is available only as a powder for the preparation of a sterile solution.

It is forbidden to prescribe during the lactation period and in the first trimester of pregnancy.

The drug is excreted mainly by the kidneys, which allows it to be prescribed in the treatment of infections of the urinary organs in small doses.

The daily volume of the drug is selected based on the patient's weight - 15-30 mg of Cephaloridine is taken for each kilogram of body weight. The drug is injected into a muscle or into a vein by jet and drip.

Cephaloridine analogues - Alipozin, Cepalorin, Ceflorin, Tseporin, Keflodin, Latorex, Lo-Ridin, Lauridin, Sefasin.

Cefalotin

The drug belongs to the group of first-generation cephalosporins. The drug causes the death of bacteria, penetrates well into the tissues of the urinary system, therefore it is successfully used to treat patients with infections of the kidneys and urinary organs.

The maximum concentration of the active substance is determined two hours after the parenteral administration of the drug.

Cefalotin is placed only in the muscle or in the vein, so the drug is available in the form of a powder for the preparation of an injection solution. During pregnancy and breastfeeding, the drug is not prescribed.

In uncomplicated forms of urinary tract infections, Cefalotin is administered at a dose of 0.5-2 grams every 6 hours. Severe diseases are treated with the introduction of the drug at a dose of 2 grams every four hours.

Cefapirin

The drug is a first-generation cephalosporin. The antimicrobial activity of the drug is expressed against gram-negative and gram-positive pathogenic bacteria. The therapeutic effect develops within two hours.

Cefapirin is produced only in the form of a powder used for the manufacture of injection solutions.

In the treatment of infectious and inflammatory pathologies of the urinary organs, the standard dosage is 3-6 grams per day, divided into 2-4 injections.

The maximum daily dosage in the treatment of complicated forms of cystitis should not exceed 12 grams.

During pregnancy, cefapirin is strictly prohibited for use in the first trimester. With caution, the medicine should be prescribed to infants up to three months.

Cephradine

Refers to first-generation cephalosporin antibiotics. After ingestion, it destroys the shell of bacterial microorganisms. The therapeutic effect begins to develop an hour after ingestion.

The drug has two dosage forms - capsules and powder for the preparation of injection solutions.

Adults are prescribed the drug for use in a daily dosage of two grams, it can be divided into 2-4 doses.

For children, the amount of the drug required for treatment is calculated based on their body weight.

In the treatment of pregnant and lactating women, Cephradine is not used.

Cefazolin

The semi-synthetic antibiotic Cefazolin is a first-generation cephalosporin drug. Of the drugs in this group, it is used most often, since it has the least toxic effect on the body.

A medicine is produced in the form of a powder used to prepare a sterile solution. Cefazolin is administered intramuscularly or into a vein. With cystitis and infections of the genitourinary organs of an uncomplicated course, the drug is administered twice a day, 1 gram each.

Severe forms of MPS infections require the introduction of Cefazolin at the same dosage, but after 6-8 hours.

The period of pregnancy and breastfeeding - contraindications to the use of the drug.

Analogues of Cefazolin in the form of a powder for injection - Reflin, Cezolin, Cefazex, Cefamezin.

Cefadroxil

The cephalosporin antibiotic, which belongs to the first generation drugs, is endowed with high antimicrobial activity. The concentration of the drug, which contributes to the destruction of bacteria, remains in the blood for 12 hours.

Treatment with Cefadroxil is contraindicated in lactating and pregnant women. In the treatment of uncomplicated forms of cystitis and other urinary tract infections, the drug is used at a dosage of 1000-2000 mg per day, mainly the daily amount is divided into two doses. Produced only in capsules.

Analogues of Cefadroxil - Cedrox in the form of tablets and powder for injection, Cedroxhexal (tablets), Cefangin (capsules).

Cefaclor

Cefaclor is a second-generation cephalosporin, the drug has an antibacterial and bactericidal mechanism of action. Used orally, it is produced in capsules, tablets and as a powder for making a suspension.

A high concentration of the drug is fixed within 30 minutes after its use. Cefaclor is approved for use during pregnancy for health reasons. For the period of treatment, breastfeeding is interrupted.

The standard dosage of Cefaclor in the treatment of mild MPS infections is 750 mg, divided into three doses. The duration of therapy is from 7 to 10 days.

Analogues - Alfacet, Ceclor, Cefaclor Stada.

Cefamandol

The antibiotic belongs to the second generation of cephalosporins. The main action is bactericidal, after entering the body, the therapeutic effect begins to develop after 30 minutes. High concentrations of Cefamandol remain in the urine for a long time.

The drug is produced in powder for injection, injected intravenously or into the muscle.

In the treatment of cystitis and other infectious diseases of the urinary organs, a medicine is prescribed at a dose of 0.5-1.0 grams every 8 hours.

If necessary, a single dosage is doubled, and the frequency of administration is up to 6 times per day.

Cefamandol is contraindicated in pregnant and lactating women, the drug is used with caution to treat infections in newborns.

Trade names (analogues) of Cefamandola - Cefamabol, Cefat, Mandol, Tartsefandol, Cefamandola nafat.

Cefotaxime

The drug belongs to the third generation cephalosporins. The drug is intended only for parenteral administration, therefore it is available in the form of a powder for the preparation of solutions.

The antimicrobial effect of the drug is to block the activity of transpeptidase.

After injection into the muscle, the highest concentration of the drug in the body is fixed after 30 minutes.

Cefotaxime is not used in the treatment of pregnant and breastfeeding women. Children under two and a half years of age are recommended to give only intravenous injections of the drug.

The standard dosage in the treatment of mild urinary tract infections is 1-2 grams every 12 hours. For intramuscular injections, Cefotaxime powder is recommended to be diluted with Lidocaine or Novocaine.

Cefotaxime analogues - Loraksim (powder d / in.), Sefotak (powder d / in.), Tax-O-Bid (powder d / in.), Fagocef (powder d / in.), Cefantral (powder d / in.). ), Cefotaxime (powder d / in.).

Cefoperazone Plus

The drug belongs to the cephalosporin series of antibiotics of the third generation. Cefoperazone destroys the shells of bacterial membranes, which leads to their death. The drug is well tolerated, rarely causes severe side effects.

The drug is available in powder, which is used to prepare a solution for injection.

Do not use cefoperazone during pregnancy and lactating women.

In the treatment of cystitis and infections of other urinary organs, mainly adult patients are prescribed 2-3 grams of medication per day, it is distributed twice and put in 12 hours.

Analogues of Cefoperazone in the form of a powder for injections - Gepacef Combi, Combicef-Pharmex, Macroceft, Magtam, Sulperazon, Prazon, Sulcef, Faytobact, Cesulpin, Cebanex, Cefazon-S, Cefopectam, Cefoperazone + Sulbactam, Cefosulbin, Cefsul, Cefsulpin.

Ceftriaxone

The drug belongs to the third generation cephalosporins. Ceftriaxone has a universal antimicrobial effect, which allows this antibiotic to be used to treat infections of almost any organ.

Ceftriaxone is a powder packaged in vials. Used to prepare solutions for intravenous and intramuscular injections. The drug is not prescribed for pregnant and lactating women.

The standard dosage in the treatment of cystitis, pyelonephritis and mild urinary tract infections is 1-2 grams per day. The drug can be administered once a day, or twice after 12 hours.

Ceftriaxone analogues in the form of a powder for injection: Avexon, Alvobak, Alcisone, Belcef, Auroxon, Blicef, Bresek, Denicef, Diacef, Xon Injections, Lendacin, Loraxon, Maxon, Norakson, Medakson, Oframax, Parcef, Promocef, Procef, Rotacef, Ratiocef -Avers, Rocephin, Rumixon, Tercef, Trimek, Toroceff, Cefaxon, Cefogram, Cefast, Cefgrin, Cefodar, Cefort, Cefolife, Cefotriz, Ceftrax, Emsef, Efmerin, Efektal.

Ceftibuten

The active substance, which belongs to the third generation cephalosporin antibiotics. Contained in a medicine called Cedex produced in the form of capsules and a powder used to prepare a suspension.

The antibiotic inhibits the formation of cells of nascent bacteria, which leads to their death.

The suspension can be used in the treatment of infants older than 6 months, capsules are prescribed after 10 years.

Medicine for pregnant and lactating women can be prescribed if there are no other ways to treat infections.

The standard dosage in the treatment of infectious diseases of the urinary tract is 400 mg per day for adults. The medicine can be taken once or twice. The course of therapy is at least 5 days.

Ceftazidime

The drug is a third-generation cephalosporin. It is considered the most effective drug in the treatment of nosocomial infections and diseases caused by Pseudomonas aeruginosa.

Produced in the form of a powder used for the preparation of solutions for intramuscular and intravenous administration.

In the treatment of cystitis and other infectious and inflammatory diseases of the urinary tract, ceftazidime is prescribed 250 mg every 12 hours.

Not intended for pregnant and lactating women.

Analogues of Ceftazidime (powder d / in.) - Auromitaz, Aurocef, Biotum, Eurozidim, Denizid, Zidane, Zacef, Lorazidim, Orzid, Tazid, Rumid, Tulizid, Trophyz, Fortazim, Ceftadim, Fortum, Ceftazidim, Ceftaridem, Emzid, Ceftum.

Cefixime

The drug is a third-generation cephalosporin. Dosage forms - tablets, suspension for the preparation of a solution for oral use.

When Cefixime is consumed with food, the maximum concentration in the tissues is reached faster.

Contraindicated in the treatment of children under 6 months, women in the lactation period. Pregnant women may be prescribed Cefixime for health reasons.

The daily dosage in the treatment of genitourinary infections is 400 mg. The drug can be taken once or twice a day. The duration of therapy is from 7 to 14 days. The suspension is used in the treatment of young children.

Cefixime's analogs:

• tablets, powder for suspension - Ikzim, Lopraks, Maksibat;
• tablets - Ceforal Solutab, Fixim, Suprax, Cefigo;
• tablets, capsules - Flamifix;
• tablets, granules for suspension - Sorcef;
• capsules, powder for suspension - Fix, Vinex;
• capsules, powder for suspension, tablets - Cefix.

cefpodoxime proxetil

The drug is a third-generation cephalosporin. The spectrum of antimicrobial action of the drug covers gram-positive, gram-negative, anaerobic and aerobic microorganisms.

The drug is available in tablets and powder for oral suspension.

Tablets are prescribed after 12 years, suspension for children older than 5 months.

In pregnancy, cefpodoxime should only be used if infections with this drug need to be treated for health reasons.

Treatment of uncomplicated forms of infectious diseases of the urinary tract is carried out by taking 400 mg of the drug per day.

The daily dosage is divided into 2 doses, you need to drink the medicine after 12 hours while eating.

Cefpodoxime analogues:

• tablets - Auropodox, Cepodem, Cefma;
• tablets, capsules - Cefpotek;
• tablets, powder for suspension - Doccef, Foxero, Cedlxim, Cefodox.

Cefodizyme

The drug belongs to the 3rd generation of cephalosporins, it is used only parenterally.

Cefodizim disrupts the formation of the shell of most gram-negative and gram-positive bacteria.

After injection, high concentrations of the active substance in the tissues are determined after 30-40 minutes.

The drug is available in vials containing powder for solution preparation.

It cannot be used in the first trimester of pregnancy; during the lactation period, when using the medicine, breastfeeding is temporarily stopped.

The standard dosage in the treatment of uncomplicated forms of MPS disease is 2 grams of the drug twice a day.

An analogue of Cefodizim is Modivid in powder for injection.

Cefpir

The drug belongs to the group of cephalosporin antibiotics of the fourth generation.

Cefpirome is highly resistant to pathogenic microorganisms. Available in powder for the preparation of sterile injectable solutions.

The drug when administered parenterally is rapidly absorbed, the therapeutic effect lasts up to 12 hours.

Treatment with the drug during breastfeeding and in all trimesters of pregnancy is contraindicated.

Analogues of Cefpirome - Isodepem, Keiten, Cefanorm (powder for r - ra).

cefepime

The drug is part of the fourth-generation cephalosporin group. The drug has a high antimicrobial activity, it is prescribed in the treatment of infections resistant to exposure to aminoglycosides and third-generation cephalosporins.

Cefepime is available as a powder for solution for injection. The drug can be used in pediatrics from two months. Pregnant women are prescribed according to indications.

In the treatment of infections, MPS is prescribed for 7-10 days in a vein or muscle. The medicine is put twice a day, 0.5-1 gram.

Cefepim analogues (powder for injections) - Abilim, Ajicef, Veksapim, Quadrocef, Denilim, Keflim, Maxinort, Kefsepim, Maksipim, Novalim, Maxicef, Pixef, Roxipim, Posineg, Septipim, Hipim, Fotsepim, Tsepim, Tsebopim, Tsefepim, Cefi, Cefimek, Cefikad, Cefotrin, Extensef, Exipim, Espim, Efipim.

Ceftolosan

The drug belongs to the new antibacterial drugs-cephalosporins.

In addition to ceftolazane, the drug includes an inhibitor of tazobactam, which enhances the antimicrobial activity of the drug. Ceftolazane, marketed under the name Zerbax, has proven effective in the treatment of patients with complicated MPS infections.

It is allowed to use Ceftolazan in combination with metronidazole, which allows you to cope with mixed pathogenic flora.

Zerbaks is approved for use in Europe and the USA, but it is still difficult to find the drug in our pharmacies.

cefotetan

The antibiotic belongs to the second generation cephalosporins. The active substance of the drug is disodium salt. Effective in the treatment of infections caused by aerobic and anaerobic microorganisms.

It is produced in the form of a powder for the preparation of an injection solution.

Cefotetan is contraindicated for children under 6 months of age, pregnant and lactating women.

Adult patients in the treatment of urinary tract infections are prescribed intravenously or intramuscularly at 0.5-1 gram twice a day.

Cefonizide

Belongs to the second generation of cephalosporins. It is used to treat urogenital infections in women, infectious and inflammatory diseases of the MPS.

It is prescribed one gram per day into a muscle or vein. Trade name Lisa. Available in powder form.

Loracarbef

Second-generation cephalosporin is effective in the treatment of community-acquired infectious lesions of the skin, urinary tract, and respiratory organs.

With pyelonephritis, 400 mg is prescribed twice a day, the duration of therapy is 14 days.

cefmetazole

It is a 2nd generation cephalosporin. The antimicrobial action is aimed at most gram-positive and gram-negative bacteria. The safety of Cefmetazole in the treatment of pregnant women has not been established.

With cystitis and pyelonephritis, the medicine is used at a dosage of 1-2 grams per day, the medicine is given twice a day.

Cefprozil

The antibiotic Cefprozil belongs to the second generation of cephalosporins. In the treatment of infectious and inflammatory diseases of the genitourinary tract, the drug is prescribed 500 mg orally, the medicine can be drunk twice. Cefprozil is not prescribed for children under 13 years of age.

Ceforanide

It belongs to the second generation cephalosporins. Inactive in the treatment of streptococcal infections. Produced in the form of a powder for the preparation of solutions for injection. Adult patients are prescribed 0.5 grams every 12 hours.

Latamoxef

The drug belongs to the third-generation cephalosporin antibiotics. During pregnancy and lactation, it is prescribed only by a doctor.

Uncomplicated MPS infections are treated by injecting 0.25 grams of drug into the muscle 12 hours later. The course of treatment on average lasts up to 10 days.

Cefpyramide

The antibiotic is a 3rd generation cephalosporin. It is resistant to beta-lactamases of most Gram-positive and Gram-negative bacteria.

In pregnancy, it is used only if there are no safer effective drugs.

Cefpyramid is injected into a muscle or into a vein, 1-2 grams per day, the drug is taken twice in 12 hours.

List of cephalosporins by generation

1. First-generation cephalosporins - Lexin, Ospexin, Cedrox Sandoz, Reflin, Cefazolin, Cesolin, Cedroxhexal, Cefalexin, Cefangin, Cefamisin.
2. Second generation cephalosporins - Abicef Farmunion, Aksef, Auroxetil, Biofuroxime, Bactylem, Zinnat, Zinacef, Zocef, Yokel, Mikreks, Spizef, Kimacef, Furexa, Cetyl, Cefur, Cefoktam, Cefumax, Cefurox, Cefuroxime, Enfexia, Cefutil, Cefamesin, Cefangin .
3. Third generation cephalosporins - Avexon, Alvobak, Alcisone, Auromitaz, Aurocef, biotum, Belcef, Bresec, Blicef, Hepatcef, Denizid, Diacef, Denicef, Eurozidim, Euroceftase, Zidane, Zoxicef, Zacef, Lendacin, Lopraks, Lorazidim, Magtam, Medocef, Medakson, Maxon, Orzid, Oframax, Parcef, Prazon-Health, Procef, Rotocef, Rumikson, Rumid, Sefotak, Sorcef, Sulperazon, Suprax, Takstam, Tazid, Trimek, Tulizid, Phagocef, Faytobakt, Fixim, Fix, Cedex, Cefast, Cesulpin, Cefix, Cefobid, Cefodar, Cefoperazone, Cefort, Cefotaxime, Cefotriz, Cefpodoxime Proxetil, Ceftazidime, Ceftriaxone, Ceftum, Enfexia, Cefamesin, Efmerin, Cefangin.
4. Fourth generation cephalosporins - Alvopenem, Aris, Doribax, Zaxter, Europenem, Carbonem, Invanz, Ifem, Ineplus, Lastinem, Bipenem, Macpenem, Mesonex, Merexid, Mero, Merobocid, Meromak, Merogram, Meronem, Meropenem, Merosize, Piminam, Prepenem , Ronem, Romen, Supranem, Tiactam, Exipenem, Sironem, Exipenem, Efectal, Cefalexin, Enfexia.

Penicillins and beta-lactam antibiotics

Penicillins are antibacterial drugs, which are based on the waste products of certain microorganisms.

They belong to the class of β-lactams and form the basis of chemotherapy, as they are used in modern medicine to treat many infectious diseases.

Penicillins are divided into natural and semi-synthetic.

Natural include:

• Penicillin (benzylpenicillin), potassium and sodium salt;
• Benzathine benzylpenicillin;
• Phenoxymethylpenicillin;
• Novocaine salt of penicillin (Benzylpenicillin procaine).

Semi-synthetic antibiotics penicillins:

• Isoxazolylpenicillins (oxacillin);
• Aminopenicillins (Amoxicillin, Ampicillin);
• Carboxypenicillins (Ticarcillin, Carbenicillin);
• Ureidopenicillins (Piperacillin, Azlocillin);
• Inhibitor-protected penicillins (Piperacillin/tazobactam, Ampicillin/sulbactam, Amoxicillin/clavulanate, Ticarcillin/clavulanate).

Penicillins are endowed with a bactericidal mechanism of action. Antibiotics block the production of peptidoglycan, a biopolymer involved in building bacterial walls. This leads to the death of microorganisms.

Inhibitor-protected penicillins inhibit the activity of enzymes that can affect the development of antibiotic resistance in microorganisms.

List of penicillin antibiotics

Antibiotics of the penicillin series are widely used in the treatment of bacterial diseases in pulmonology, gastroenterology, urology, gynecology, ophthalmology.

Penicillins are prescribed for the treatment of sexually transmitted infections, purulent-inflammatory processes on the skin.

Broad spectrum penicillins

Ampicillin

The drug is a semi-synthetic antibiotic, has a wide spectrum of action.

After ingestion, it is quickly and evenly distributed throughout the tissues of the respiratory, digestive and genitourinary systems.

In the urine, high concentrations of unchanged Ampicillin are created, which makes it possible to successfully use the drug in the treatment of cystitis.

Release form - tablets, powder for oral suspension, powder for injection.

During pregnancy, the drug is prescribed for health reasons, breastfeeding should be discontinued for the duration of Ampicillin therapy.

The drug is taken after 6 hours, the daily dose in the treatment of uncomplicated forms of MPS is 1 gram, in severe cases the dose is increased to 3 grams.

Pivampicillin

A semi-synthetic antibiotic endowed with a wide spectrum of action Pivampicillin is used only orally. Available in tablets.

The standard dosage in the treatment of urinary tract infections is from 0.2 to 0.4 grams at a time, the frequency of taking tablets is 3-4 times. The trade name of Pivampicillin is Pondocillin (Pondocillin).

Carbenicillin

Refers to semi-synthetic antibiotics, the drug is endowed with a wide spectrum of action.

Release form - powder for the preparation of a solution for intramuscular and intravenous injections.

During pregnancy, the appointment of Carbenicillin is prohibited.

In severe infections of the genitourinary tract, the antibiotic is administered drip, a daily dosage of 200 mg per kilogram of weight.

With a mild course of diseases, the drug is administered intramuscularly at 1-2 grams every 6 hours.

Amoxicillin

The semi-synthetic antibiotic Amoxicillin is acid-resistant; when it enters the digestive tract, it is absorbed almost without residue.

A wide spectrum of action of the drug allows you to prescribe it to fight infections of different body systems.

It is rarely used to eliminate cystitis, it is more suitable for the treatment of urethritis and pyelonephritis.

Forms of release of the drug - tablets, capsules, powder for injection, suspension and solution for oral use.

The standard dosage in the treatment of MPS infections is 0.5 grams, the drug is taken three times a day. With a protracted and severe course of the disease, a single dosage increases to 1 gram.

Children are prescribed mainly suspension, tablets and capsules, it is desirable to use after 10 years.

When treating pregnant women with the drug, you need to select the minimum dosage.

Analogues of Amoxicillin - Amoxicillin Solutab, Amoxil, Amofast, Graximol, V-Mox, Gramox, Iramox, Ospamox, Hikoncil, Flemoxin Solutab.

Beta-lactamase sensitive penicillins for the treatment of cystitis

Benzylpenicillin

The drug is obtained from penicillium - a mold fungus.

Benzylpenicillins have a high antimicrobial activity, this is especially expressed in the effect on staphylococci and streptococci. These antibiotics are poorly absorbed in the intestinal tract, so they are used only parenterally.

Benzylpenicillin does not affect bacteria that secrete penicillinase.

The drug is available in powder for solution for injection. The daily dosage of the drug in the treatment of uncomplicated forms of MPS infections is 1000,000-2,000,000 IU, it is divided into 4-6 times. In most cases, benzylpenicillin is administered intramuscularly.

When treating pregnant women with benzylpenicillins, caution should be exercised.

Analogues - Benzylpenicillin Sodium Salt powder for injection, Penicillin G Sodium Salt Sandoz powder for injection.

Penicillins resistant to beta-lactamase for cystitis

Oxacillin

The drug is a semi-synthetic antibiotic with a narrow spectrum of action.

Oxacillin is resistant to bacteria that produce penicillinase. Does not affect certain types of gram-negative bacteria.

The medicine is produced in tablets and in the form of a powder for the preparation of injection solutions.

During pregnancy and during breastfeeding, the drug should be administered with caution.

The standard dosage in the treatment of cystitis is 3 grams per day. The course of treatment lasts from 7 to 10 days.

Beta-lactamase inhibitors

Sulbactam

Synthetic antibiotic Sulbactam refers to drugs with a beta-lactam structure. It is similar in structure to penicillins.

Sulbactam inhibits chromosomal beta-lactamases, which causes the death of bacterial cells.

Antibiotics containing Sulbactam are available in tablets, in solution for injection. This medicine is recommended for the treatment of severe MVS infections.

Reviews about the effectiveness of the drug are mostly positive. The dosage is selected individually.

Pregnant and lactating women are allowed to prescribe the drug if there are no other effective drugs for infectious diseases.

Sulbactam is contained in such preparations as Bakperazon, Paktotsef, Sulcef, Sulmagraf, Sulperazon, Cefpar SV, Cefbaktam, Sulzontsef, Sulmover, Cebanex, Sulperacef, Sultasin, Unazin, Ampisid, Libaccil, Trifamox IBL, Broadsef-S.

Piperacillin + Tazobactam

The drug is a combined antibiotic consisting of the semi-synthetic antibacterial substance piperacillin sodium and beta-lactomase inhibitor tazobactam sodium.

The drug is endowed with broad antimicrobial activity. The medicine is used only intravenously.

For the treatment of urinary tract infections, it can be used from 12 years of age. The drug is administered intravenously at 4.5 grams every 6 hours. The course of treatment is on average 10 days.

The use of the drug is limited during lactation and childbearing.

The trade names of the drug are Tazocin, Tacillin J.

Combination of penicillins

Ampicillin with an enzyme inhibitor: Ampisid, Sulbacin, Ampisulbin, Unazine, Ampicillin + Sulbactam-Farmex.

Amoxicillin with enzyme inhibitor: Abiclav, Amox-Apo-Clav, A-Clav-Pharmex, Amoxic-Apo-Clav, Amoxiclav Quiktab, Amoxiclav, Amoxicomb, Augmentin, Amoxil-K, Amoxicillin-Clavulanate, Amoxicillin I Clavulanate Potassium Aurobindo, Amoxicillin+ Clavulanic Acid-Pharmex, Amoxiplus Farmunion, Amoxicillin + Clavulanate-Credopharm, Bactoclav, Betaclav, Clavam, Camox-Clav, Clavamitin, Clamox, Clavicillin, Coact, Neo Amoxiclav, Medoklav, Novaklav, Rekut, Panklav, Rapiclav, Teraklav, Flemoklav Solutab, Trifamox Ibl.

Ticarcillin with enzyme inhibitor: Timentin.

Piperacillin with an enzyme inhibitor: Zopercin, Aurotaz-R, Piperacillin-Tazobactam-Teva, Tazar; Revotaz 4.5, Tazlen.

• Oxampicin;
• Vampilox;
• Ruclox Lb.

Combined antibacterial agents

Combined antibacterial drugs: Grandazol, Zoloxacin, Zoxan-Tz, Ofor, Norzidim, Polimic, Stillat, Roksin, Tifloks.

Spiramycin in combination with other antibacterial agents: Tsiprolet A, Tsiprotin, Tsipro-Tz, Tsifran St, Tsifomed-Tz.

Levofloxacin in combination with other antimicrobial agents: Grandazol.

Ciprofloxacin and ornidazole: Orcipol.

Amphenicols

Levomycetin

The drug is the only representative of antibiotics from the amphenicol class used in practical medicine.

Levomycetin has a wide spectrum of action, has a bacteriostatic effect.

In the treatment of urinary tract infections, it is used if the inflammation is caused by the influenza bacillus.

The drug is produced in tablets and in powder for the preparation of a solution for intravenous and intramuscular injections.

Levomycetin is not prescribed for pregnant and lactating women, children under three years of age.

Depending on the severity of the infection, the drug is prescribed to adults at 250-500 mg up to 4 times a day.

Levomycetin in injections is given at 500-1000 mg 2-3 times a day. The duration of the course of treatment is from 5 to 15 days.

Oxyquinolines

These antibiotics are synthetic drugs. They inhibit the activity of gram-negative bacteria, disrupting the activity of their enzyme system.

Oxyquinolines are endowed with antiprotozoal and antibacterial action. Widely drugs from this group were used to treat patients with intestinal infections in the middle of the last century.

Now they are rarely used, since cases of severe adverse reactions have been identified.

A rare exception in terms of popularity in modern medicine is given to the drug from the group of Oxyquinolines Nitroxoline.

Nitroxoline

The drug is effective in the treatment of infections caused by gram-positive and gram-negative bacteria, as well as some types of fungi.

The popularity of the antibiotic is due to its rapid entry from the gastrointestinal tract, which minimizes the risk of adverse reactions.

Nitroxoline after ingestion accumulates in the urine, and therefore this antibiotic shows its high efficiency in the treatment of pyelonephritis, urethritis, cystitis.

Nitroxoline release form - tablets. They are prescribed in a daily dose of 0.4 grams, which is usually divided into 4 doses. If necessary, the dosage can be doubled.

Analogues of the drug - 5-Nock, Uroxoline, Nitroxoline Forte.

Nitrofurans

They are synthetic antibacterial agents. In terms of their effectiveness, most antibiotics are inferior, therefore they are recommended for use in the treatment of mild infections of the urinary organs, diseases caused by protozoal microorganisms and intestinal infections.

Nitrofurans are oxygen acceptors, which, when used, leads to disruption of cellular respiration of pathogenic bacteria.

The concentration of drugs affects the type of antimicrobial effect, nitrofurans can act bactericidal or bacteriostatic.

Furadonin

The active substance of the drug is nitrofurantoin. Furadonin is well absorbed in the gastrointestinal tract, the drug is endowed with a wide spectrum of antimicrobial activity.

It is prescribed for the treatment of infections of the urinary organs - cystitis, pyelonephritis, inflammation of the urethra.

The drug is produced in powder for the preparation of a suspension and in tablet form.

The standard single dose of the drug is 0.1-0.15 grams, the tablets are drunk 4 times a day. With acute infections, the course of therapy reaches 10 days.

Furadonin is not prescribed for pregnant and lactating women; it has been used in pediatrics since one month.

Furagin

The medicine is effective against infections caused by streptococci and staphylococci. It has no systemic impact.

After ingestion through the intestines, it first enters the lymph, preventing the spread of bacteria through the lymphatic tract.

After a few hours, it reaches the genitourinary system, where it accumulates in the urine in high concentrations.

Furagin is prescribed for the treatment of patients with acute infectious diseases - with pyelonephritis, cystitis, prostatitis.

Available in tablets. A single dosage is from two to four tablets, which must be taken four times a day. The course of treatment is up to 10 days, if necessary, after two weeks it can be repeated.

Pregnant and lactating women, as well as children under 6 years of age, Furagin is not prescribed.

Furazolidone

The drug has an antimicrobial effect. In addition, Furazolidone has an immunostimulating effect and reduces the production of toxins by pathogenic microorganisms, which accelerates the reduction of symptoms of diseases.

Furazolidone is prescribed for children older than one month; during pregnancy, the drug can be taken with the permission of a doctor.

In case of kidney damage, it is prescribed with caution, a contraindication to the use of the drug is a severe degree of renal failure.

The standard dosage for the treatment of urinary tract infections in adults is 2 tablets 3-4 times a day. The duration of therapy should not exceed 10 days.

Nitrofurantoin

The drug is endowed with a pronounced antimicrobial effect, in most cases the drug is prescribed for the elimination of urinary tract infections. Available in tablets.

Dosage in the treatment of cystitis, pyelitis, pyelonephritis - 150-600 mg per day, this amount of medication is divided into 4 doses. The duration of taking Nitrofurantoin is from 5 to 10 days.

The drug is contraindicated during breastfeeding, during pregnancy, babies up to one month.

Furazidin

The active substance of the drug is furazidin potassium. Furazidin has an antiprotozoal and antimicrobial effect, while simultaneously enhancing the functioning of the immune system.

The medicine is produced in tablets, capsules and in the form of a powder for preparing a solution inside.

Contraindicated for children under 4 years of age, lactating and pregnant women. Not used for severe damage to kidney tissue.

Furazidin in patients with cystitis, pyelitis, pyelonephritis is prescribed in a daily dose of 150-300 mg, which must be divided into three doses. The duration of the course of therapy is 7, maximum 10 days.

Macrolide group

Macrolides are antibiotics whose chemical structure is based on a macrocyclic lactone ring.

In the group of macrolides, the clinical significance is expressed in relation to gram-positive coccal bacteria and to intracellular pathogens of infections (chlamydia, mycoplasma, campylobacter, legionella).

Antibiotics from the macrolide class are considered the least toxic.

Macrolides interfere with protein production on the ribosomes of a pathogenic cell.

The main action is bacteriostatic, but the use of macrolides in high concentrations leads to a bactericidal effect against pneumococci, pathogens of diphtheria, whooping cough.

In addition to the antibacterial mechanism of action, macrolide antibiotics are endowed with a moderate anti-inflammatory and immunomodulatory effect.

Macrolides are divided into:

• Natural - Erthromycin, Josamycin, Spiramycin, Midecamycin;
• Semi-synthetic - Clarithromycin, Azithromycin, Roxithromycin, Midecamycin acetate.

Antibiotics from the group of macrolides are used to treat infections of the upper and lower respiratory tract, sexually transmitted diseases, infections of the skin and oral cavity.

Not all drugs from this group are effective in the treatment of infectious and inflammatory diseases of the urinary tract.

macrofoam

The main active ingredient of the drug is Midecamycin. Macropen is available in tablets and granules for oral suspension.

The drug is effective in the treatment of infectious and inflammatory diseases of MPS, including those developing under the influence of chlamydia, mycoplasmas, ureaplasma.

Assign Macropen three times a day, 400 mg. For children, the dosage is selected based on their weight.

During pregnancy and breastfeeding, the drug should be allowed by a doctor. Macropen treatment of children under three years of age is contraindicated.

Rulid

The active active ingredient of the drug is Roxithromycin. The drug is prescribed in the treatment of genitourinary infections if they are caused by chlamydia, staphylococci, legionella, streptococci.

Often used to treat respiratory diseases.

The drug is produced in tablets, effective therapeutic concentrations of Rulid remain throughout the day after taking a single dose.

The drug is contraindicated for the treatment of pregnant and lactating women, children under the age of four years.

In pathologies of the urinary tract, Rulid is prescribed twice a day, 150 mg.

Remora

The main action is antibacterial and bacteriostatic, the active ingredient is Roxithromycin.

The drug does not accumulate in the body, with internal use it is quickly absorbed in the gastrointestinal tract.

Available in capsules, tablets and tablets intended for suspension.

The drug Remora is contraindicated in pregnant and lactating women, do not prescribe it to infants under 2 months old.

The daily dose in the treatment of urinary tract infections for adults is 300 mg, it can be divided into two doses.

RoxyHexal

The drug is based on roxithromycin. The drug is well absorbed, adverse reactions rarely develop.

In the first trimester of pregnancy, treatment with RoxiGeksal is prohibited; in the future, the medicine should be used under the supervision of a physician.

RoxyGeksal is available in tablet form. With the development of MPS infections in adults, it is prescribed in a daily dosage of 300 mg, the medicine can be taken once a day.

Wilprafen

The active ingredient of the drug is josamycin. Wilprafen has a long therapeutic effect, this drug can be prescribed to patients allergic to penicillins.

Vilprafen has proven its effectiveness in the treatment of cystitis, pyelonephritis, prostatitis, urethritis.

Release form - tablets, suspension. The standard single dosage is 500 mg, it should be divided into 2-3 times a day.

In severe infections, the daily amount may be increased to 3 grams.

The teratogenic effect of Vilprofen has not been established, however, during pregnancy and lactation, the drug is prescribed only by a doctor.

Roxithromycin

Semi-synthetic antibacterial agent is available in the form of tablets.

Roxithromycin in the treatment of MPS infections, including those caused by pathogens of sexually transmitted diseases, is prescribed twice a day for 0.15 grams. During pregnancy and lactation is not used.

Azithromycin

Refers to broad-spectrum antibiotics. In the foci of inflammation accumulates in high concentrations, which leads to a bactericidal effect. Available in tablets.

Azithromycin is contained in Azivok (capsules), Sumamed (tablets, powder for suspension).

In acute infections of the genitourinary tract, Aziromycin is taken once at a dose of 1 gram. For pregnant and lactating women, the medicine is prescribed with the permission of the doctor.

Sulfonamides

They belong to the first class of antibacterial agents. Before the discovery of penicillins, they were widely used.

In recent years, the use of sulfonamides in medicine has decreased due to their low activity compared to modern antibiotics and high toxicity.

The main effect of sulfonamides is bacteriostatic. Antimicrobial activity is associated with a violation of the formation by pathogenic microorganisms of the substances necessary for their normal growth.

The therapeutic effect of sulfonamides depends on the correct dosage. Insufficient dose or early discontinuation of therapy leads to the emergence of bacterial resistance.

Sulfonamides are prescribed for the treatment of infections of the upper respiratory tract and respiratory tract, infections of the digestive tract, skin and urinary organs, osteomyelitis, sepsis, abscesses.

Co-trimoxazole

The drug consists of two active ingredients - trimethoprim and sulfamethoxazole.

The bactericidal effect is expressed by blocking the metabolism of protozoa and bacterial cells.

Co-trimoxazole is contraindicated during pregnancy and lactation, do not prescribe the drug to children under two months old.

The drug is prescribed for pyelonephritis, acute and recurrent forms of cystitis. The dosage regimen for patients over 12 years of age is two tablets every 12 hours.

It is important to observe equal intervals between taking the tablets, this allows you to maintain a constantly high concentration of sulfanilamide in the body.

Sulfadimethoxine

The drug is effective against most gram-positive and gram-negative bacteria.

Sulfadimethoxine is usually prescribed for unspecified infections or if low sensitivity of pathogens to specific antibacterial agents is detected.

The medicine is produced in the form of tablets and powder for oral administration.

During pregnancy and lactation, Sulfadimetoksin is contraindicated.

Sulfadimetoksin on the first day of treatment of genitourinary infections is taken once at a dose of 2 grams, then the daily dose of the drug is one gram. Tablets are taken after 24 hours. The course of therapy is from 7 to 14 days.

Baktiseptol-Health

The drug is produced in the form of a suspension, contains two antimicrobial substances - sulfamethoxazole and trimethoprim.

The medicinal effect of Bactiseptol is to inhibit the synthesis of bacterial cells and to disrupt their metabolic processes.

The medicine shows good results in the treatment of acute and chronic forms of cystitis, pyelonephritis, urethritis.

It is prescribed to patients over 12 years of age, three teaspoons three times a day. The course of therapy is up to 14 days.

During pregnancy and lactation, Baktiseptol-Health is prohibited for use.

Bactrim

The drug consists of sulfamethoxazole and trimethoprim. The antibacterial action of the drug covers most gram-positive and gram-negative bacteria.

The drug is produced in tablets and in suspension. Effective in the treatment of pyelonephritis, cystitis, prostatitis, gonorrhea in women and men.

It is prescribed for patients older than three years, during the period of bearing a child and while breastfeeding is contraindicated. Suspension from 12 years old is applied 10 ml twice a day after 12 hours. Treatment should continue for at least 5 days.

Bactrim's analogs:

• tablets - Biseptrim, Bi-Sept-Formac, Raseptol, Triseptol, Sumetrolim, Oriprim;
• suspension for children - Bebitrim, Bi-Tol;
• syrup - Soluseptol;
• tablets, concentrate d / in, suspension for oral use - Biseptol.

Phytopreparations

The impact of phytopreparations on the human body is determined by active substances - alkaloids, tannins and essential substances, glycosides, microelements.

The effect of medicinal herbs is not always only positive; an overdose of some plants leads to poisoning. The use of herbs has its contraindications.

Phytopreparations in the treatment of acute diseases should be used only in combination with the treatment prescribed by the doctor.

The characteristic features of herbal preparations include:

• Gradual development of the therapeutic effect;
• Possibility of use only orally or externally;
• High efficiency in the restoration of the body after illness.

In the complex treatment of urinary tract infections, herbal teas are used, which have a diuretic, anti-inflammatory, immunomodulatory and hemostatic effect.

Phytolysin

A complex herbal preparation has an antispasmodic, diuretic and antimicrobial effect on the body.

The ability of Phytolysin to dissolve small stones in the bladder and kidneys has been proven.

It is prescribed as an auxiliary treatment for cystitis, prostatitis, pyelonephritis, urolithiasis.

The phytopreparation is produced in a paste, which is used to prepare a suspension.

The drug almost does not cause adverse reactions, it can be used to treat urinary tract infections in pregnant women and young children.

Monurel

The composition of the drug Monurel includes cranberry extract and ascorbic acid. The drug blocks the reproduction of bacteria on the epithelial layer of the urinary tract.

Monurel is prescribed in the complex therapy of urinary tract infections, as well as a means for the prevention of relapses in chronic forms of cystitis, pyelonephritis. Produced in tablet form.

Monurel should be taken one tablet at a time after emptying the bladder at night. The course of therapy is one month.

With a recurrent form of cystitis, the phytopreparation is prescribed for use for two weeks for three months.

During pregnancy and lactation, Monurel is not used.

Kanefron

Kanefron helps to reduce the excretion of protein from the body, which allows it to be prescribed for the treatment of chronic forms of glomerulonephritis.

Increased urination when taking the drug accelerates the removal of toxins from the urinary system.

Kanefron is effective in the treatment of cystitis and pyelonephritis, occurring without severe intoxication. In the acute phase of diseases, the phytopreparation must be combined with antibiotics.

Kanefron is approved for use in children from one month old, lactating and pregnant women.

The standard dosage of the drug for patients over 12 years old is 2 tablets three times a day. Drops are prescribed 10-15 three times a day, depending on age.

cystone

Plant components endow the drug Cyston with anti-inflammatory and nephrotic effects.

Under the influence of the herbal remedy, small stones dissolve, inflammation decreases, diuresis increases, pain decreases.

Cystone is produced in tablets. In addition to the treatment of cystitis and pyelonephritis, it is used for urolithiasis, gout, urinary incontinence in women.

The standard dosage of the drug for patients over 14 years of age is two tablets twice a day. The drug is sometimes taken for 4-5 months.

lingonberry leaves

Lingonberry leaves are used in inflammatory diseases of the urinary tract as an antimicrobial and diuretic agent. Phyto raw materials help cleanse the kidneys and bladder.

In the treatment of urological pathologies, a decoction of the leaves is used, taken warm, ¼ cup up to three times a day. Treatment continues for 2-3 weeks. If necessary, the course of phytotherapy can be repeated.

Other antibacterial agents used in the treatment of cystitis

Fosfomycin preparations

Bernie, Urofosfabol, Monural, Ureacid, Forteraz, Urofoscin, Fosmitsin, Phosphoral, Fosmural, Cistoral, Fosfotsin, Espa-Fotsin.

bacteriophages

Bacteriophage Klebsiel Pneumonia, Sextaphage Pyobacteriophage, Pyobacteriophage.

Effective antibiotics prescribed for cystitis in men and women

The first antibiotics began to be produced in the 40s of the last century, and when exposed to them, most bacteria died, which made it easy to cope with the most severe and previously incurable diseases.

But over time, bacteria to antibacterial drugs have learned to develop resistance.

A decrease in the therapeutic effect to date has been found in:

• Biseptol. The activity of the drug against Escherichia coli is from 25% to 85%;
• Ampicillin. In 30% of cases, the medicine does not help eliminate infections caused by E. coli;
• groups of nitrofurans. Preparations Furagin and Furadonin are used as prophylactic agents;
• Groups of non-fluorinated quinols. These antibiotics compared with fluorinated agents are endowed with a narrow spectrum of action;
• First generation cephalosporins. It has been established that Cefadroxil, Cephradin, Cefalexin and a number of other drugs are inactive against gram-negative infectious agents.

IT'S IMPORTANT TO KNOW : .

Antibiotics effective in the treatment of chronic cystitis

In the treatment of chronic cystitis, it is first necessary to determine the sensitivity of the pathogenic flora to antibiotics.

The cause of the disease is established by laboratory tests of urine tests and a number of diagnostic procedures.

The complete cure of a patient with a chronic form of cystitis is determined not only by the choice of the drug, but also by the appointment of the correct dose and the duration of the main course of therapy.

In a chronic process, agents belonging to the fluoroquinolone group of antibiotics are recommended for use.

Their antimicrobial action is directed against most pathogenic pathogens of urogenital infections.

Fluoroquinolones are effective even if the inflammation is caused by Pseudomonas aeruginosa.

Fluoroquinolones used in the treatment of chronic cystitis:

• Norfloxacin;
• Ofloxacin;
• Ciprofloxacin;
• Norbaksin;
• Pefloxacin;
• Levofloxacin;
• Flexid;
• Zanocide.

The best antibiotics used for acute cystitis

With the development of an acute inflammatory process in the bladder, treatment should be started immediately, without waiting for the results of tests for the sensitivity of the organism to antibacterial drugs.

Therefore, acute cystitis is usually treated with antibiotics with a wide spectrum of activity.

Without antibacterial agents, acute cystitis may subside under the influence of herbal remedies and other medicines, but in this case, the chronic course of the disease is inevitable.

The remaining bacteria will multiply in the urinary tract, and cause inflammation with all the ensuing symptoms under the influence of the slightest provoking factor.

The dosage of antibiotics, their type and duration of therapy should be determined only by a doctor.

The most effective antibiotics used in the treatment of acute inflammation of the bladder include:

• Co-trimoxazole;
• Monural;
• Fosfomycin;
• Furadonin;
• Nitroxoline;
• Nolicin;
• Nevigramon;
• Norbactin;
• Digital.

Cystitis with blood

Cystitis with the release of blood (hemorrhagic cystitis) indicates a pronounced inflammation in the walls of the organ, causing an increase in the permeability of the vascular walls.

With urine, both a small amount of blood and individual clots can be excreted.

Before prescribing treatment for hemorrhagic cystitis, it is necessary to exclude other diseases with similar symptoms - glomerulonephritis, oncology, urolithiasis, bladder injury.

Acute flowing cystitis with the release of blood is usually treated in a hospital.

If this is not possible, then the patient at home must strictly follow all the doctor's instructions.

It is mandatory to prescribe drug therapy, consisting of:

• antibiotics. Broad-spectrum drugs are prescribed if the causative agent of the disease is not identified. In case of detection of certain strains of bacteria or viruses, antibiotics of a narrow spectrum of activity are prescribed;
• Antispasmodics and painkillers;
• Hemostatic drugs;
• Preparations that strengthen the vascular walls;
• Vitamin complexes.

Drug therapy in each case is selected individually.

When choosing medicines, the doctor takes into account not only the nature of the infection, but also the symptoms of the disease, the degree of bleeding.

Antibiotics for cystitis for pregnant and lactating mothers

Treatment of cystitis that develops at any stage of pregnancy should be as gentle as possible. The expediency of prescribing drugs is determined by the doctor, based on the diagnostic data.

The best known and most commonly used antibiotics for MPS infections during pregnancy can adversely affect the fetus. Unsafe in this regard and folk remedies.

In the treatment of cystitis in pregnant women, preference is given to those antibacterial drugs that accumulate directly in the bladder cavity.

Such medicines include:

• Monural;
• Kanefron;
• Cyston.

In rare cases, Amoxiclav is used. Installation can replace systemic treatment - the introduction of a drug through a catheter into the bladder. Assign installation at an early date in special cases.

Features of the choice of antibiotics in the treatment of women with cystitis

In women, due to the anatomical features of the genitourinary organs, cystitis develops much more often compared to men.

To exclude other diseases of the pelvic organs, patients are assigned an ultrasound scan, a gynecologist's examination, urine collection for analysis and bakposev.

Antibiotics and the duration of their administration are selected based on the severity of the symptoms and the identified changes.

Women are most often prescribed Amoxicillin, sulfonamides, Fosfomycin, fluoroquinolone antibiotics to fight the infection. If necessary, use two or three drugs at the same time. The duration of the course of therapy reaches 2-3 weeks.

The development of cystitis indicates a decrease in the functioning of the immune system. Therefore, doctors often recommend the use of vitamin complexes, a sparing diet, and giving up bad habits.

In chronic course of cystitis, courses of antibiotics are repeated 2-3 times.

Features of eliminating cystitis in men

The main active ingredient of the drug is Icelandic moss, the usnic acid contained in the plant successfully fights mycobacteria, staphylococci and streptococci.

Cetrazine also includes propolis, St. John's wort and an extract from a plant called andrographis.

The absorption of the drug and the enhancement of its therapeutic effect is provided by pancreatin.

The natural antibiotic Cetrazine does not cause dysbacteriosis and can be used for cystitis in pregnant women and children.

The standard course of treatment is 10 days, provided that one tablet is taken three times a day.

Cetrazine has found its application in urological and gynecological practice.

The best antibiotics according to reviews

Clinical use data and feedback from patients show that the most effective antibiotic for cystitis in modern medicine is Monural.

The drug is taken once, quickly suppresses the activity of pathogenic microorganisms and improves the bactericidal properties of urine.

Discomfort symptoms noticeably decrease within 2-3 hours after taking Monural.

This drug is effective only in acute inflammation in the bladder. The appropriateness of its use should be determined by a qualified doctor.

Antibiotics such as Nitroxoline, Nevigramon, Normaks, Norbaktin, Nolitsin also differ in their antibacterial effect.

If signs of an ascending infection are detected, antibiotics should be combined with sulfa drugs (5 NOCs, Biseptol).

But you need to remember that an effective antibiotic can only be if it is selected individually based on the symptoms of inflammation, the type of infectious agent, and comorbidities.

Treatment and prevention of cystitis without the use of antibiotics

Without special indications, antibiotics should not be prescribed. With cystitis, their use is justified if the disease occurs with fever, severe symptoms, or if it is characterized by a recurrent course.

In mild cases of inflammation, cystitis is often successfully treated with the following herbal remedies:

• Kanefron;
• Cyston;
• lingonberry leaf;
• Monurel;
• Phytolysin paste.

To speed up recovery and reduce the risk of acute cystitis becoming chronic, it is recommended during the treatment period:

• Observe half-bed or bed rest;
• Warm up the lower abdomen with heating pads;
• Increase fluid intake. Herbal decoctions of chamomile, dill seed, calendula, cranberry and lingonberry juice are especially useful for cystitis;
• Follow a diet. In the acute phase of the disease, the use of irritating foods is necessarily excluded - too salty and spicy dishes, smoked meats, fatty foods.

It is not worth delaying a visit to the doctor in the absence of positive dynamics from the use of herbal remedies.

The sooner specific treatment is started, the less likely it is to develop unnecessary complications.