Features of cystitis management in outpatient therapeutic practic
https://doi.org/10.51793/OS.2024.27.1.003
Abstract
Background. Cystitis is one of the most common urinary tract infections undergoing treatment on an outpatient basis. In Russia, up to 36 million cases of the disease are registered annually. The main causative agent of uncomplicated cystitis, detected in 75% of cases, is E. coli, in the remaining cases, the etiological agents are S. saprophyticus, Klebsiella spp. and a number of enterobacteria, extremely rare – anaerobic microorganisms, chlamydia and ureaplasma. The article discusses predisposing factors and the pathogenesis of acute uncomplicated cystitis.
Results. The aim of treatment of acute uncomplicated cystitis is rapid eradication of the pathogen, leading to clinical and microbiological recovery, as well as prevention of relapses of the disease. Uncomplicated acute cystitis in most cases is treated in outpatient settings. The basis of pharmacotherapy of acute cystitis is antibacterial drugs. The appointment of an antibacterial drug is carried out empirically when the symptoms of the disease are detected, taking into account the alleged etiology of cystitis and the clinical and pharmacological characteristics of the drug, with mandatory consideration of the current state of antibiotic resistance. The optimal choice of the drug and the antibiotic therapy regimen contributes to a faster recovery and a reduction in the risk of chronic disease.
Conclusion. Detailed information about the existing regimens of antibiotic therapy for acute cystitis is presented in the article, as well as the main indications for the appointment of antibacterial drugs. The results of studies on the effectiveness of the drug cefixime in the treatment of acute uncomplicated cystitis, including the cystitis of pregnant women, are analyzed.
About the Authors
D. S. Sukhanov
Federal State Budgetary Educational Institution of Higher Education St. Petersburg State Pediatric Medical University of the Ministry of Health of the Russian Federation
Россия
Россия
Dmitriy S. Sukhanov, clinical pharmacologist, Dr. of Sci. (Med.), Associate Professor of the Department of Propaedeutics of Internal Diseases
2 Litovskaya str., Saint Petersburg, 194100
V. A. Filippovich
Educational institution Grodno State Medical University of the Ministry of Health of the Republic of Belarus
Беларусь
Беларусь
Vladimir А. Filippovich, urologist, And. of Sci. ((Med.), Associate professor of the 2nd department of surgical diseases at the educational institution
80 Gorky str., Grodno, 230009
Yu. S. Alexeeva
Federal State Budgetary Educational Institution of Higher Education St. Petersburg State Chemical and Pharmaceutical University of the Ministry of Health of the Russian Federation;
Россия
Россия
Yulia S. Alekseeva, PhD student of the Department of Pharmacology and Clinical Pharmacology
14 lit. A Professor Popov str., Saint Petersburg, 197022
E. V. Timofeev
Federal State Budgetary Educational Institution of Higher Education St. Petersburg State Pediatric Medical University of the Ministry of Health of the Russian Federation
Россия
Россия
Eugene V. Timofeev, Dr. of Sci. (Med.), Professor of the Department of Propaedeutics of Internal Diseases
2 Litovskaya str., Saint Petersburg, 194100
References
1. Karpov E. I. Urinary tract infections in outpatient practice. Terapiya. 2017; 3: 89-95. (In Russ.)
2. Zaitsev A. V., Perepanova T. S., Gvozdev M. Yu., Arefieva O. A. Urinary tract infections. Part 1 / Guidelines No. 57. M., 2017. 32 p. (In Russ.)
3. Streltsova O. S., Krupin V. N. Cystitis: diagnosis and treatment: textbook. 3rd ed. N. Novgorod: Publishing house of the Nizhny Novgorod State Medical Academy, 2018. 48 p. (In Russ.)
4. Clinical recommendations ″Cystitis in women″ edited by the All-Russian public organization ″Russian Society of Urologists″, 2021. (In Russ.)
5. Tyutyunnik V. L., Mikhailova O. I., Kan N. E., Mirzabekova D. D. An integrated approach to the treatment of chronic recurrent uncomplicated cystitis during pregnancy. Akusherstvo i ginekologiya. 2022; 8: 124-130. (In Russ.)
6. Nashivochnikova N. A., Krupin V. N., Zubova S. Yu. Prevention of postcoital cystitis in women. Meditsinskii almanakh. 2022; 2 (71): 63-71. (In Russ.)
7. Khodyreva L. A., Zaitsev A. V., Bernikov A. N., Kupriyanov Yu. A., Stroganov R. V., Arefeva O. A. Acute and recurrent cystitis. What do we know? RMZh. 2020; 11: 69-74. (In Russ.)
8. Bader M. S., Loeb M., Leto D., Brooks A. A. Treatment of urinary tract infections in the era of antimicrobial resistance and new antimicrobial agents. Postgrad Med. 2020; 132 (3): 234-250. DOI: 10.1080/00325481.
9. Palagin I. S., Sukhorukova M. V., Dekhnich A. V., et al. Research group "DARMIS-2018". Antibiotic resistance of pathogens of communityacquired urinary tract infections in Russia: results of the multicenter study "DARMIS-2018". Klinicheskaya mikrobiologiya i antimikrobnaya khimioterapiya. 2019; 21 (2): 134-146. DOI: 10.36488/cmac.2019.2.134-146. (In Russ.)
10. Wang S., Zhao S., Zhou Y., Jin S., Ye T., Pan X. Antibiotic resistance spectrum of E. coli strains from different samples and age-grouped patients: a 10-year retrospective study. BMJ Open. 2023; 13 (4): e067490.
11. Kuzmina A. V., Titova A. R., Polikarpova T. S. and others. Class effects of fluoroquinolones: dysglycemia and mental disorders. Lechaschi Vrach. 2018; 10: 87. (In Russ.)
12. Grayson M. L., Cosgrove S. E., Crowe S. M., et al. Kucers’ the use of antibiotics: a clinical review of antibacterial, antifungal, antiparasitic and antiviral drugs. Seventh edition. Taylor & Francis Group, 2018. 4891 р.
13. Kresken M., Körber-Irrgang B., Biedenbach D. J., Batista N., Besard V., Cantón R., García-Castillo M., Kalka-Moll W., Pascual A., Schwarz R., Van Meensel B., Wisplinghoff H., Seifert H. Comparative in vitro activity of oral antimicrobial agents against Enterobacteriaceae from patients with community-acquired urinary tract infections in three European countries. Clin Microbiol Infect. 2016; 22 (1): 63. e1-63.e5. DOI: 10.1016/j.cmi.2015.08.019.
14. Candel F. J., Matesanz D. M., Barberán J. New perspectives for reassessing fosfomycin: applicability in current clinical practice. Rev Esp Quimioter. 2019; 32 (1): 1-7. PMID: 31131586; PMCID: PMC6555164.
15. Practical guide to anti-infective chemotherapy. Ed. L. S. Strachunsky, Yu. B. Belousov, S. N. Kozlov. MAKMAH, 2007. (In Russ.)
16. Aghamali M., Sedighi M., Zahedi Bialvaei A., Mohammadzadeh N., Abbasian S., Ghafouri Z., Kouhsari E. Fosfomycin: mechanisms and the increasing prevalence of resistance. J Med Microbiol. 2019; 68 (1): 11-25.
17. Dybowski B., Jabłońska O., Radziszewski P., Gromadzka-Ostrowska J., Borkowski A. Ciprofloxacin and furagin in acute cystitis: comparison of early immune and microbiological results. Int J Antimicrob Agents. 2008; 31 (2): 130-134. DOI: 10.1016/j.ijantimicag.2007.08.021.
18. Diffuse parenchymal lung diseases. Ed. M. M. Il’kovich. M.: GEOTAR-Media, 2021. 440 p. (In Russ.)
19. Khonsary S. A. Goodman and Gilman’s The Pharmacological Basis of Therapeutics. Surg Neurol Int. 2023; 14: 91. DOI: 10.25259/SNI_184_2023.
20. Belov B. S. Cefixime in the treatment of bacterial infections. RMZh. 2013; 3: 147-153. (In Russ.)
21. Ajmal M., Zamir A., Rehman A. U., Imran I., Saeed H., Majeed A., Aziz M., Alqahtani F., Rasool M. F. Clinical pharmacokinetics of cefixime: a systematic review. Xenobiotica. 2023; 53 (3): 149-162.
22. A prospective open randomized cross-sectional study of the comparative pharmacokinetics and bioequivalence of Cefixime EXPRESS (INN: cefixime), dispersible tablets, 400 mg (LEKKO CJSC, Russia) and Suprax ® Solutab® (INN: cefixime), dispersible tablets, 400 mg (Astellas Pharma Europe B. V., the Netherlands) in healthy volunteers.
23. Strategy and tactics for the rational use of antimicrobial agents in outpatient practice: Eurasian clinical recommendations. Ed. S. V. Yakovleva, S. V. Sidorenko, V. V. Rafalsky, T. V. Spichak. M.: Pre100Print Publishing House, 2016. 144 p. (In Russ.)
24. Zyryanov S. K. Study of the comparative kinetics of dissolution of cefixim preparations. Farmateka. 2016; 10: 67. (In Russ.)
25. Mukhina M. A., Leonova M. V. New oral dosage forms of antibiotics. Lechebnoe delo. 2012; 1: 16-22. (In Russ.)
26. Galkin V. V., Dovgan, E. V., Kozlov S. N., Rafalsky V. V. Cefixime in comparison with ciprofloxacin in acute uncomplicated cystitis: a clinical and economic study. Clinicheskaya mikrobiologiya and antimikrobnaya khimioterapiya. 2012; 14 (1): 59-66. (In Russ.)
27. Laurent O. B., Kogan M. I., Sinyakova L. A. Rational therapy of recurrent lower urinary tract infections. Results of a prospective observational program to evaluate the effectiveness and safety of the use of Ceforal® Solutab® and Uro-Vaxom® in patients with recurrent uncomplicated lower urinary tract infections (FLORA). Urologiya. 2015; 4: 11-18. (In Russ.)
28. Clinical guidelines "Urinary tract infections during pregnancy". Ed. All-Russian public organization "Russian Society of Obstetricians and Gynecologists. Russian Society of Urologists", 2022. (In Russ.)
29. Rafalsky V. V., Dovgan E. V., Kozyrev Yu. V. et al. Efficacy and safety of cefixi- me and amoxicillin/clavulanate in the treatment of asymptomatic bacteriuria in pregnant women: a multicenter randomized prospective study. Urologiya. 2013; 5: 24-29. (In Russ.)
Review
For citations:
Sukhanov D.S., Filippovich V.A., Alexeeva Yu.S., Timofeev E.V. Features of cystitis management in outpatient therapeutic practic. Lechaschi Vrach. 2024;(1):21-26. (In Russ.) https://doi.org/10.51793/OS.2024.27.1.003
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