Cystitis and Metronidazole

Metronidazole (Metronidazole, Vagivid) is an extremely efficient primary-line antimicrobial drug for the treatment of a large range of transmittable pathologies.

For several years (manufactured in 1958) it has actually been actively recommended for the relief of numerous localization of transmittable procedures. In urology and gynecology, metronidazole with cystitis is shown for the defeat of the urogenital system by anaerobes, facultative and protozoa microbes.

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Instructions for usage

Metronidazole is utilized generally in the advancement of multifocal urogenital trichomoniasis. Vaginal Trichomonas in guys, in addition to cystitis, can manifest itself:

  • prostatitis,
  • epididymitis,
  • vesiculitis
  • cooperite,
  • balanoposthitis or cicatricial constricting of the urethra.

In women and females, it triggers the advancement of not just cystitis, however likewise inflammatory procedures in the mucous lining of the vaginal area, and the cervical canal of the uterus, adds to the development of cervical disintegration, purulent tubo-ovarian developments and myomatous growths in the uterus. All of these pathologies can cause impaired reproductive function, pregnancy issues and fetal death.

According to lots of client examines about metronidazole, even monotherapy, based on all the suggestions from the directions for usage for the drug, offers a fast and efficient outcome.

Local and focal inflammatory procedures in the MP, in addition to physical pain and discomfort signs, can end up being the beginning point for the spread of infection in the rising instructions and infection of the whole urinary tract system. The usage of metronidazole in particular does for cystitis is because of its home of actively reducing the activity of the pathogen that triggered the inflammatory response.

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Features of antimicrobial action

Metronidazole for cystitis is recommended due to its unique antimicrobial action, based upon bactericidal, protistocidal (antimicrobial) and DNA-tropic residential or commercial properties, selectively acting upon the transmittable plants. Compared to lots of drugs with antimicrobial residential or commercial properties.

The activity of metronidazole appears right away after its intro (change) into the cell structure of a transmittable representative. In this case, the procedures of interaction of numerous protein portions (nitro substances and ferridoxins) in the cell of the pathogen are catalyzed and the biotransformation of the drug into the active substance (metabolites) happens.

They have a damaging impact on the cellular proteins of the pathogen and the structure of RNA and DNA of cells, interrupting the synthesis and procedures of cell recreation. The entire procedure is accompanied by obstructing of cellular respiration and the development of an aggressive kind of oxygen inside the cell, ruining the cell membrane, which is the factor for its death.

The drug reveals excellent activity versus lots of gram (+) and (-), coccal and obligate anaerobes, spore-forming and non-spore-forming microbes.

There are other efficient drugs for cystitis:

  • Ciprofloxacin.
  • Furazolidone.
  • Diclofenac.
  • Nitroxoline.
  • Levomycetin.

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Pharmacokinetic residential or commercial properties

An essential element of the drug is bioavailability (approximately 100%) and relatively fast absorption when taken orally, which minimizes the requirement for parenteral (by injection) administration. Injections are recommended for serious procedures of sore with enaerobic, or blended infections of the main nerve system, or when it comes to the advancement of extraintestinal amebiosis (reoccurring colitis).

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The sedimentation of metronidazole in plasma is rather low (approximately 20%). It is well dispersed in numerous body fluids and tissues, offering a high concentration in the tissues. It is excreted from the body by the kidneys rather gradually.

The long-lasting action of the drug, its fast intro into the tissue and liquid structure of the body, in mix with a high concentration and an active bactericidal home, made it possible to recommend metronidazole for cystitis in females as a one-time loading dosage of treatment.

Due to its pharmacokinetics, the drug manifests itself well with rectal and intravaginal administration, applying a regional impact on the transmittable representative. This home is accountable for the advancement of numerous types of the drug – for oral administration, intravenous, rectal (in the kind of suppositories) and intravaginal (suppositories and lotions) administration.

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Rules for utilizing the drug

Despite all the suggestions for admission in the directions for usage for the drug, there is no single day-to-day dose routine. How to take metronidazole with an illness such as cystitis is figured out just by the medical professional, based upon the center of the illness, the client’s private specifications (weight, age) and background pathologies. In some cases, the day-to-day dose might be minimized or increased, or the medical professional will recommend a single loading dosage (when it comes to an intense symptom of the scientific photo of the illness or worsening of a persistent procedure).

The directions are just basic standards. Treatment starts with the consultation of the optimum dosage of the drug to acquire the needed drug concentration in the tissues. Further usage accompanies a minimum dose, as upkeep treatment:

  • Tablets – 250 mg two times a day. If needed, improved treatment (when numerous groups of pathogens are determined) – 3 times a day with an eight-hour period.
  • Vaginal lotions or gels – 5 g. Twice a day. Applicator insertion into the vaginal area in the early morning and night for 7 days.
  • Parenteral administration (drip) – 0,7 g. Three hips daily, course for 10 days. During menstruation, treatment is not cut off.
  • Tablets or vaginal suppositories – 2 tablets daily with a period of 7 hours. Course – a week.
  • Metronidazole tablets are taken throughout meals, cleaned down with a lot of liquid (water, juices, fruit beverages, milk -100, 150 mg).

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To identify the efficiency of the usage, whether metronidazole is assisting or not, the medical professional compares the blood test results prior to beginning treatment and after it ends.

Drugs are not recommended if the hidden illness of cystitis are colds (influenza, ARVI, ARI), and when the client needs to all at once take other medications. They can considerably lower the efficiency of metronidazole, or vice versa, it will improve their impact, which increases the danger of adverse effects.

Metronidazole for kids, females throughout pregnancy and lactation

In any dose kind and dose, the drug adversely impacts pregnancy. Its home of active absorption, quickly conquers the placental barrier, which can be made complex by abnormalities of fetal advancement, specifically in the preliminary duration of pregnancy (1st trimester).

For the very same factor, it is not recommended for females throughout breastfeeding, as it rapidly collects in breast milk. If there is an immediate requirement for admission, an alternative option needs to be discovered and change breastfeeding with synthetic mixes.

The drug in the kind of options is authorized for usage in kids from the minute of birth, however it needs to be kept in mind that its impact is lasting, given that it is excreted from the kid’s body within 25 hours.

In tablet kind, metronidazole is not recommended to kids till school age (6 years), however in the kind of suppositories, approximately 18 years.

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What are the contraindications

Despite the efficiency of metronidazole treatment for urogenital infections and cystitis, its usage can be restricted by particular contraindications (hypersensitivity, allergic reaction and private intolerance to the drug) and be accompanied by lots of adverse effects in the kind of:

  • practical conditions in the intestinal system,
  • neurological conditions
  • conditions in the system of hematopoiesis and hemostasis,
  • advancement of kidney pathologies.

With such symptoms, the medical professional carries out an immediate correction of the dosage and the treatment course, or its total cancellation with replacement for alternative treatment.

Risks of establishing dependency to metronidazole

According to the conclusion of researchers, the resistance of the bacterial plants to drugs of the anti-bacterial group has actually reached a threatening state today. We are under the risk of a go back to the pre-antibiotic period, which will offer germs with total dominance over people. It is still within male’s power to avoid this procedure. Today, a great deal of work is being done amongst doctors on the right and affordable prescription of drugs. But the mindset to the treatment of the clients themselves is extremely essential.

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If a weekly course of treatment is recommended, it cannot be disrupted by yourself, even with complete self-confidence that you will be treated. The self-abbreviated treatment course is a timeless choice of the germs that are the most resistant to the drug and can transferring their residential or commercial properties to subsequent microbial generations. When the very same pathogen consequently goes back to the client or his relative, treatment will be much lengthy and hard.

It is similarly essential to abide by the conditions and frequency of admission recommended by the medical professional, which guarantees the impact of treatment. Self-medical diagnosis and recommending drugs for oneself on the guidance of pals, and even on the suggestion of a pharmacist, is not advised. Only a physician can take into consideration all the subtleties and intricacies of the pathological procedure when recommending drugs.

Only using metronidazolone as directed (in accordance with the directions for usage) in a strictly metered order can lower the danger of establishing resistance (dependency) of germs to the drug.

Reviews of physicians and clients

Patient examines about the drug are the most favorable. Those who were dealt with in compliance with all medical suggestions keep in mind a fast and relatively simple remedy for cystitis. Doctors note that the prescription of metronidazole, a number of unreasonable, for years, has actually caused the development of pressures of germs more resistant to it. In some cases, its efficiency does not go beyond 44% and is typically accompanied by complex responses and adverse effects.

Cost and analogues of metronidazole

The costs for the drug are democratic and budget-friendly. They depend upon the dose kind and maker: our pharmaceutical market provides options at a rate of 25 rubles. for 100 ml suppositories from 45 p. Tablets from 9-10 rubles. Imported maker – from 70 to 130 rubles.

It is easy to change the drug with an analogue if needed. There are a great deal of them on the medicinal market – more than 20 producers produce drugs in numerous does and cost classifications. These are drugs – “Metrogyl”, “Metressa”, “Intezol”, “Efloran”, “Tricaside”, “Batsimex”, “Klion-D”, “Metrozol”, “Ginalgin”, “Mistol”, “Flagil”, ” Trichopol “,” Dentagel “,” Gravagin “and other drugs in the kind of tablets, suppositories, creams or gel. All of them correspond from the perspective of evidence-based medication and vary from the initial just in the kind of release and dose routine.

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Regardless of the strength of the symptom of the center of cystitis, with targeted and prompt treatment, it reacts well to treatment. In contemporary drug treatment, there is a large range of anti-bacterial drugs, however metronidazolone still maintains the status of a first-line drug in the treatment of pathologies of a bacterial-inflammatory nature.

Tatyana Jakowenko

Editor-in-chief of the Detonic online magazine, cardiologist Yakovenko-Plahotnaya Tatyana. Author of more than 950 scientific articles, including in foreign medical journals. He has been working as a cardiologist in a clinical hospital for over 12 years. He owns modern methods of diagnosis and treatment of cardiovascular diseases and implements them in his professional activities. For example, it uses methods of resuscitation of the heart, decoding of ECG, functional tests, cyclic ergometry and knows echocardiography very well.

For 10 years, she has been an active participant in numerous medical symposia and workshops for doctors - families, therapists and cardiologists. He has many publications on a healthy lifestyle, diagnosis and treatment of heart and vascular diseases.

He regularly monitors new publications of European and American cardiology journals, writes scientific articles, prepares reports at scientific conferences and participates in European cardiology congresses.

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