Corresponding, effective and timely treatment of any IMP will lead to significantly higher frequency of symptomatic and bacteriological cures and better prevent reinfection. Unfortunately, treatment can lead to antibiotic resistance to pathogens and review bacteria and adversely affect the gut and vaginal flora, so it is important to consult a doctor immediately and choose it correctly.
Clinical advice for the treatment of acute simple cystitis
The American Society of Infectious Disease Experts (IDSA) and the European Society of Microbiology and Infectious Diseases (ESCMID) published clinical recommendations for treatment in 2011 and in 2011. This document becomes a valuable reference for the IMP office. This manual discusses important factors in choosing the best treatment:
- The nature of resistance to urethra;
- The sensitivity of myeloid bacteria to antibacterial drugs;
- Possibility of side effects of antibacterial drugs.
As for sensitivity, this leadership points out two important facts:
- In recent years, the stability of urology against antibiotics has been improved.
- The nature of resistance indicates great geographical variability between countries and regions.
Therefore, due to the continuous development of drug resistance, the development of new tools and research, these recommendations are regularly modified to indicate the advantages and inefficiency of the drug. Based on recommendations and research, it is best to meet their requirements for medications for simple cystitis: the following substances:
- Phosphorus;
- Nitrofuran protein.
The following selection criteria were used: pharmacokinetics, interactions, hit possibility (probability of microorganisms being sensitive to antibiotics), development of drug resistance, specific use of IMPS, effectiveness, side effects, dose frequency, dose, treatment time, treatment time, cost.
The study included the following drugs: amoxicillin (with or without claric acid), nitrosulfonine, sulfamide, trimellin, trioxazole, ciprofloxacin, noffloxacin, exofluoroproxicin, exooxyamine and triaminoaminophosphate.
First-line treatment for characterizing lower urinary tract infection
Table 1. The first line of treatment for cystitis
| substance | dose | Duration of treatment |
| phosfomicin trometamol | 3 g single dose | One dose (once) |
| Nitrofuran protein | 50-100 mg four times a day | 5-7 days |
phosfomicin trometamol
phosfomycin, opened in 1969, is a representative of new phosphorus-like antibiotics.
Active substance: Phosphorus is effective. Release Form: Particles used to prepare solution, in package 1 or 2 packs, dosage of phosphorizine 3 g/bag, 2 g/bag.
It refers to the clinical and agronomic groups, antibiotics (phosphate derivatives).
Action range
phosfomycin has various bactericidal activities relative to the following methods:
- Staphylococcus (Stacium);
- Enterococcus (Enococcus spp. );
- Haemophilus genus;
- Most gut Gram-negative bacteria, including 95. 5% E. coli, produces swelling spectrum beta-lactamase (BLR);
- E. coli strains produce metal-β-lactamase that is protein-sensitive to phosphorus;
- Citric acid.
- Enterobacter spp. ;
- Klebsiella spp. , Klebsiella pneumonia;
- Morganella Morganii;
- Proteus mirabilis;
- Pseudomonas;
- Serratia spp.
The particularity of drugs
- Trometamol Phosphorus is only used to treat acute simple cystitis in a single dose of 3 g, and is not suitable for pyelonephritis.
- If you take it before eating, it is best to absorb it.
- Reach high concentrations in the urine and maintain high levels for more than 24 hours.
In several studies, the clinical and microbiological effectiveness of phosphatosis was compared with other antibacterial agents in the first line with simple cystitis. The clinical efficiency of one dose (3 g) of phosphoglobulin was 91% (treatment occurred in 91% of patients). This index is comparable to nitrosulphonamide (93%), trimethylsulfonylmethoxazole (93%) and fluoroquinolones (90%) in acute simple cystitis.
Advantages of phosphate treatment
The levels of microorganisms that treat phosphorus (80%) are lower than those of comparable antibiotics 88-94%. However, a recent meta-analysis of 27 studies did not reveal differences in the effectiveness of phosphogenic and other antibiotics in the treatment of cystitis and found the following facts:
- Phosfomycin can lead to a significant reduction in adverse reactions, which is most important, including pregnant women.
- Another benefit is the treatment of multiple organisms. Several in vitro studies have shown that phosphorus is correlated with anti-Vancico-resistant Staphylococcus aureus and a Gram-negative rod that produces BLR.
- Effectively treat IMP caused by Streptococcus pneumoniae. Enterobacteriaceae produces carbapenicillin enzyme (dose 3 g, repeated every 48-72 hours).
- It has minimal side effects on the body. This suggests a high frequency of E. coli susceptibility in the region, whereas women often use phosphorus proteins with simple cystitis;
- The convenience of single dose mode.
Indications
- Acute cystitis (bacterial origin);
- aggravated recurrent cystitis (bacterial origin);
- Urethritis (bacterial nonspecific);
- Asymptomatic bacteria in pregnant women;
- Small animals after operation;
- Prevent the devil.
Dosage and application method
| Simple treatment of acute cystitis | Recurrent/heavy forms of imp | Prevent the ghost |
| Adult - 3. 0 g (1 pack) once
Children (from 5 years old) - 2. 0 g once |
Adult - 3. 0 g twice, the second time is received 24 hours later | First technology: 3. 0 g operation/diagnosis procedure 3 hours before
The second trick: 3. 0 g after 24 hours of junior high school |
Recommendations for use
- Follow all instructions on the label.
- phosphomycin is usually in only one dose.
- If your doctor does not prescribe, please do not take large/smaller quantities or longer.
- It can be used simultaneously/after eating.
- phosfomycin is a powdered drug that must be diluted with water before use. Do not take dry powder without adding water.
- Dissolve a bag of 1/2 cup cold water, mix immediately and drink. You can add more water to the same glass, shake carefully immediately and drink water to ensure the full dose.
- Do not mix with hot water.
- Very good overnight. There will be longer rupture between urination, which will ensure that the medication in the bladder has a longer presence and a more effective effect.
- Store moisture and heat in the original packaging at room temperature.
Other Instructions:
- After 2-3 days, the symptoms cannot be completely passed immediately;
- If the symptoms do not disappear within 3 days of treatment and there will be fever or other new complaints, it is necessary to contact a urologist.
- Before applying the patient, it is recommended to consult a doctor to ensure that the phosphorus protein is a suitable antibiotic for treatment. Additionally, urine analysis may be required before and after taking the medication.
Contraindications:
- Children under 5 years of age;
- Allergic reactions to components;
- Severe renal failure.
General side effects:
- Nausea, stomach disorder, mild diarrhea;
- Headache, dizziness;
- Itching or vaginal discharge (very rare).
Drug interactions
It is not recommended to consume simultaneously with plum acetamide to avoid weakening the effects of phosphorus.
Therefore, the convenience of a single dose state is associated with resistant Gram (resistant Gram-negative rod), causing simple and immature, simple cystitis, , , , ,The minimal trend of lateral damage makes Phosphorus a useful choice for the treatment of MVP infections (cystitis, urethritis).
Nitrofuran protein
Active substance: nitrofluranine. Release Form: Tablet, dosage 100 mg, 50 mg.
It is an antibacterial agent, an antibacterial agent according to the clinical and agricultural groups.
Nitrofluranine associated with the synthesis of nitrofluorouria was initially presented in the form of microcrystalline. In 1967, macrocyclic crystal forms with improved gastrointestinal tolerance can be provided.
Currently, there are two main types of nitrofluorinine proteins: large crystal form and a mixture of microcrystalline and large crystal form (25 mg of macrocrystalline and 75 mg of monohydrate). In the patent dual delivery system of the Russian Federation, the mixed species are not registered and are not circulated.
Mechanism of action
The mechanisms of bacterial activity of nitrofluorotextrin include several sites:
- Inhibit ribosomal broadcast;
- Damage bacterial DNA;
- Intervention with Crebs cycle.
Nitrofluorinine and:
- More than 90% of the intestinal strains cause the cerebellum;
- Enterococcus, including resistance to Wancluss;
- Klebsiella spp;
- proteus spp. ;
- Staphylococcus (gold and saprophytes) are usually susceptible.
There is little resistance to the drug, which may be due to multiple areas of the drug. However, proteins, serrated and Pseudomonas have natural resistance to nitrosoflurane.
Nitrofuranella may also be another option for oral antibacterial treatment for acute simple cystitis caused by bacterial production of BLR.
Pharmacokinetics. Absorption during eating will improve. The serum concentration of nitrofluranine is low or not defined by standard dose, and the prostate content is not detected. It is mainly excreted in urine, where the concentration of the drug (from 50 to 250 mg/ml) can easily exceed 32 mg/ml MPC.
Insulin nitrate should not target significant renal failure (creatinine clearance<60 m/min) prescribed, but studies have observed that the drug is highly efficient in patients with creatinine clearance of 60-30 mL/min.
Safe for pregnant women and children.
Indications:Cystitis (bacterial origin) treatment and prevention.
dose. It is prescribed separately by a urologist based on the severity of the status, duration and severity of the symptoms.
The usual dose of adult cystitis:
- Take 4 oral times from 50 to 100 mg for 1 week or at least 3 days after urinary sterility. The usual dose for adults to prevent cystitis:
- Take 50 mg orally once a day before going to bed. Dosages for treating cystitis in children:
- 1 month and above: 5–7 mg/kg/day (up to 400 mg/day) oral doses. The usual childhood doses for preventing cystitis:
- More than 1 month: 1 to 2 mg/kg/day (up to 100 mg/day) orally 1-2 receiving.
Most experts agree on the advice of 5-day medication for acute simple cystitis. Studies have shown that early clinical cures range from 79% to 95%, and microbial therapies range from 79% to 92%. In the overall clinical effectiveness study, they demonstrated general equivalence between nitrofluorane, prescribed for 5 or 7 days, trimethanesulfonyloxyzole (beads), cyproflofloxacin and single doses of triaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoaminoamHowever, the rate of microbial curing continues to show favorable effects on comparative drugs.
Make suggestions to patients
- It is necessary to follow all prescriptions and instructions from your doctor in the instructions for the medication.
- Do not use it in large quantities or smaller quantities or longer.
- It is best to take nitrofluranine with food (increased bioavailability).
- It is recommended to observe reception throughout the prescribed period. Symptoms may be earlier, but treatment cannot be stopped when the infection is completely eliminated. Dosage can increase the risk of further development of antibiotic resistance and recurrence.
- Nitroscopytrypsin does not treat viral infections, such as colds or flu.
side effect
General side effects:
- Headache, dizziness;
- Gas formation, stomach disorders;
- Mild diarrhea;
- Itching or vaginal discharge.
Much less often found:
- watery or bloody diarrhea;
- Sudden pain or discomfort in the chest, breathing, dry cough;
- Difficulty in breathing;
- Fever, chills, soreness, fatigue, inexplicable weight loss;
- Numbness, tingling or pain in the hands or legs;
- Liver problems - nausea, stomach pain, itching, fatigue, loss of appetite, dark urine, clay stools, jaundice (yellow skin or eyes);
- Rubid Syndrome - joint pain or fever, swollen glands, muscle pain, chest pain, vomiting, abnormal thoughts or behaviors, rash found.
Severe side effects may be more likely in older people, long-term patients or in weak people.
Contraindications:
- Serious diseases of kidney excretion function;
- renal failure;
- Oligouria;
- 6-Glucose phosphate dehydrogenase failure;
- Pregnant;
- Age up to 1 month;
- Allergic reactions to components;
- XN Phase II-III;
- Cirrhosis;
- Chronic hepatitis;
- Acute porphyria;
- breast-feeding.
Application in pregnancy
Category of medications related to pregnancy: in (according to U. S. Health Service – according to U. S. Health Service). It is believed that the drug will not harm unborn children early in pregnancy. It is contraindicated during the last 2-4 weeks of pregnancy.
Nitrofluorane is able to penetrate into breast milk and is not prescribed during lactation.
Special Instructions
- The risk of peripheral neuropathy is increased in the presence of anemia, diabetes, severe MON, violation of electrolyte balance.
- Nitroflate trypsin is not used to treat prostatitis, renal cortical lesions, and purulent Cervical inflammation. For pyelonephritis, no prescription is prescribed due to inefficiency.
- Nitroflurane can give abnormal results using certain laboratory glucose (sugar) in the urine.
Drug interactions
- The use of fluoroquinolones is incompatible.
- Antacids based on magnesium triritate and magnesium lactonate, and the antibacterial activity of nitrofuran protein are taken at the same time.
- There is no regulation to prevent channel secretion, as they increase the toxicity of nitrogen (increased blood content) and reduce bactericidal properties (increased urine content).
Nitroflurane is considered the first treatment for acute simple cystitis:
- The effectiveness of the 5-day course;
- The risk of side effects is very small, causing damage to a person's normal bacterial flora;
- Minimum resistance to bacteria;
- The effectiveness is comparable to other antibacterial drugs.