MODERN COMBINED TREATMENT OF ACUTE COMPLICATED CYSTITIS IN WOMEN

DOI: https://doi.org/10.29296/25877305-2023-06-16
Issue: 
6
Year: 
2023

Associate Professor M. Davidov(1), Candidate of Medical Sciences; M. Meltsina(2); N. Bunova(3); A. Metelkin(4, 5)
1-E.A. Vagner Perm State Medical University
2-Polyclinic of the Perm Regional Center of the Federal Micro-Biological Agency
of Russia
3-City clinical policlinic №2, Perm
4-City clinical policlinic №1, Perm
5-Policlinic №3 CRB, Perm

One of the most common human diseases is acute cystitis, which affects mainly women. Annually in Russia there are 26-36 million cases of acute cystitis. The most severe contingent is considered to be patients with acute complicated cystitis, whose treatment efficiency is only 64.6–85.8% or less. Objective. Evaluation of the analgesic effect, efficacy and tolerability of phenazopyridine in combination with the antibiotic cefixime for the treatment of acute complicated cystitis in women of working age. Material and methods. A multicenter randomized open study of phenazopyridine in combination with the antibiotic cefixime in the treatment of 144 women with an average age of 42.2±3.8 years with acute complicated cystitis was performed in 5 polyclinics of the Perm region. In 55.6% of patients, the risk factors were not urological, but therapeutic and gynecological diseases. The international scale of cystitis ACSS, visual analogue scale (VAS) of pain, laboratory and bacteriological methods were used. The main group consisted of 72 women who received oral phenazopyridine (Urinalgin F) at a dose of 200 mg 3 times a day for 2 days and cefixime 400 mg 1 time per day for 7 days. The comparison group consisted of 72 women who received orally cefixime at the same dose for 7 days and No-spa (drotaverine hydrochloride) 80 mg 3 times a day for 2 days. Results. In the main group, a strong analgesic and antidysuric effect of phenazopyridine was noticed, which was confirmed by the analysis of the ACSS and VAS scales. Already after 20 minutes, an analgesic effect was detected, after 2 days pain symptoms and dysuria completely disappeared in 70 (97.2%) patients, despite the high initial level. The pain index on the VAS scale decreased from the initial 6.5 points to 0.03 points, i.e. by 217 times. The clinical efficacy (recovery) of combination therapy with phenazopyridine and cefixime was 91.7%, bacteriological efficacy was 91.8%, leukocyturia disappeared earlier, and the period of temporary disability decreased by 28.6%. In the comparison group, clinical (83.3%) and bacteriological (83.6%) efficiency was lower. Urinalgin F showed a favorable safety profile, only 1 (1.4%) patient had a side effect (nausea). Conclusion. Phenazopyridine (Urinalgin F) is a drug with high effectiveness and tolerability that eliminates pain, dysuria and other symptoms of acute complicated cystitis, eliminates leukocyturia earlier and more significantly, and reduces the period of temporary disability by 28.6%. Combined therapy of acute complicated cystitis with the antibiotic cefixime and the selective analgesic Urinalgin F has a high clinical and bacteriological efficacy.
Keywords: 
urinary tract infection
acute complicated cystitis
etiology
risk factors
treatment tactics
pain
dysuria
conservative treatment
phenazopyridine (Urinalgin F)
cefixime.

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