Sumamed - instructions for use. Sumamed is effective, but dangerous Drug interactions with other drugs

There may be a venereal or tuberculosis infection, an allergic reaction to food, medicines or cosmetics, mechanical damage.

Urethritis is characterized by pain when urinating, frequent false urge, discharge from the urethra, burning and itching, violation of the skin (ulcers, abrasions).

In men, urethritis manifests itself rapidly, already on days 2-4, primary symptoms appear. After a few days, the discomfort reaches a maximum, the patient may experience swelling, and the body temperature rises.

In the absence of treatment or improperly selected therapy, the acute phase becomes chronic, which is difficult to treat. If the drug course is not followed or if it is interrupted, a relapse of the disease is possible.

Treatment depends on the nature of the disease. The patient undergoes a series of tests that identify the pathogen. Chlamydial urethritis is most often diagnosed; according to statistics, at least 5-10% of men are infected with it.

The risk group includes young, sexually active people who often prefer to change partners. All forms of urethritis are contagious and sexually transmitted quickly.

Azithromycin for urethritis: what are its benefits?

The best drug for the treatment of common chlamydial urethritis is Azithromycin. It is a semi-synthetic antibiotic from the azolide subclass.

Compared to erythromycins, it has many advantages:

• the drug is rapidly absorbed into the blood;
• has a prolonged action (up to 68 hours);
• well penetrates cell membranes;
• resistant to acids and not destroyed in the gastric environment.

It is worth considering that Azithromycin is not a universal medicine. It is suitable for the treatment of chlamydial and microplasmic urethritis, copes well with ureaplasma, treponema, Borrelia's spirochete, but has little effect on enterococci. It is less effective for the destruction of staphylococci and streptococci; for the treatment of urethritis of the corresponding nature, it is better to use erythromycin.

The main purpose of the drug is to suppress protein synthesis. In moderate concentration, it slows down the growth of bacteria and stops their reproduction. When the dosage is increased, the drug completely destroys the pathogenic flora, preventing the development of a secondary infection. The medicine retains its antibacterial effect for several days.

The drug is available in the form of coated tablets or capsules, packaged in blisters.

The main active ingredient is azithromycin dihydrate. The same component is included in other pharmaceutical preparations. The most popular is Sumamed, which is a powder for preparing an aqueous suspension.

The course of use and the effectiveness of the drug

Azithromycin is a first-line antibiotic, it is prescribed at the very beginning of the disease.

Azithromycin for urethritis in men - dosage and time of admission are prescribed by the doctor, self-medication is excluded.

• Most often, a single dose of 0.5 g (1 standard tablet or capsule) is prescribed for 2-3 days.
• The drug should be washed down with plenty of clean non-carbonated water (at least 1 glass).
• Sometimes urologists recommend another treatment option - 2 tablets of 0.5 g are taken once, followed by a break.

The best option for taking the drug is one hour before a meal or 2 hours after it. However, for some stomach conditions, your doctor may recommend taking the tablets with food. It slightly reduces the rate of absorption of active substances, but practically does not affect the effectiveness of the drug. When treating with Azithromycin, citrus fruits, especially grapefruits, should not be consumed. The substances that make up their composition, in combination with the active components of the drug, have a depressing effect on the heart muscle.

Contraindications and side effects

Like other potent drugs, Azithromycin has a number of contraindications.

During treatment, it is recommended to strictly adhere to the dosage prescribed by the doctor. Exceeding the required dose may cause headache, dizziness, nausea, vomiting, stomach pain, diarrhea, or constipation. In some cases, there is a temporary decrease in visual acuity or skin rash, drowsiness, impaired appetite, increased anxiety. After discontinuation of the drug, all unpleasant symptoms disappear.

How to supplement the treatment?

Antibiotics actively affect the pathogenic flora, killing existing pathogenic bacteria and preventing the penetration of new ones. However, these drugs also have a negative effect on the body: they weaken the immune system, contribute to the occurrence of fungal infections.

The use of complementary drugs will help to avoid negative effects: antimycotic pills, vitamin complexes, immunomodulators.

Patients are recommended a therapeutic diet that excludes heavy, fatty, fried foods. Vegetables and fruits, cereals and soups, dairy products, lean meat and sea fish will help to improve the patient's condition.

When treating with antibiotics, you must completely abandon alcohol. Ethyl alcohol reduces the effectiveness of the drug and worsens the patient's condition. The menu can be supplemented with complexes with vitamins B, A, E and C, as well as preparations of iron, potassium, magnesium and zinc.

Good hygiene is essential... External preparations will help speed up recovery: industrial ointments, gels and creams, rectal suppositories. Decoctions of medicinal herbs are actively used, suitable for oral administration, baths, compresses, douching and lotions.

Treatment of urethritis with Azithromycin should be carried out under the supervision of a physician. The drug is prescribed at the very beginning of the disease and has a detrimental effect on the pathogenic microflora. After the first course, immunostimulating and antifungal drugs are prescribed to reduce the negative consequences of taking antibiotics.

It must be remembered that antibiotics for urethritis are the main method of treatment. You should not try to treat diseases only with traditional medicine. Full recovery cannot be achieved this way, and time will be wasted. The disease itself will worsen and take on a chronic form. This article discusses the effective and common types of antibiotics. It is worth noting that when the first signs of the disease appear, it is recommended to contact a specialist. The doctor will diagnose and prescribe tests, according to the results of which he will determine effective antibiotics. The factor that provoked the onset of the disease directly determines the appropriate type of antibiotic.

The main types of antibacterial agents used

In the modern pharmaceutical world, there is a huge selection of antibiotics, and each of them is endowed with specific properties. Some types of bacteria are sensitive exclusively to a specific drug, while others are susceptible to several. Finding the right antibiotic is critical. Taking antibiotic pills that are unsuitable for the treatment of a particular case, there is a risk not only of not being cured, but also of completely aggravating the situation. We offer drugs with a wide spectrum of action, the so-called universal remedies, but it is also important to be extremely careful with them, you need to know the dosage and duration of the course of treatment. The following broad-spectrum antibiotics are commonly prescribed to treat urethritis:

• Doxycycline is often prescribed for urethritis. The peculiarity of the medicine is that, regardless of the stage of the disease, it effectively affects the bacteria. It has been proven that the course of treatment with "Doxycycline" is one of the most effective.
• "Azithromycin" is used for urethritis because of its ability to stop the growth of the number of bacteria as soon as possible and kill the existing ones.
• "Sumamed" with urethritis acts like the same "Azithromycin". It is often prescribed, since it is considered not only effective, but also safe for the human body.

Female urethritis

The simplest complication of female urethritis is cystitis.

There is an opinion that urethritis, due to the anatomical features of the urethra, is an exclusively male disease, but this is not the case. Unfortunately, women are also susceptible to this disease, the only difference is that their symptoms are weaker. The female urethra and lower genital tract infections are rarely isolated. You can get infected sexually or descending, that is, if there is a focus of infection in the body. There is also a unique route of infection that is unique to women - the ascending route, that is, the infection can enter the body after a non-sterile gynecological examination.

The most effective antibiotics for the treatment of urethritis in women

• "Cephalosporin";
• Spectinomycin and Cefaclor;
• "Metronidazole", "Benzydamine", "Iodovidone" (suppositories);
• Levorin and Nystatin;
• "Tetracycline" (tablets);
• "Acyclovir".

Male urethritis

Men feel the symptoms of the disease very intensely.

The male half of humanity, as mentioned above, is more susceptible to urethritis due to the physiology of the body. This ailment in men is accompanied by the same symptoms as in women, but in a more pronounced form. The urethra is affected by the same pathogens of the inflammatory process. The reasons can be as unprotected sexual intercourse, infectious diseases, and abuse of spicy food, hypothermia. Men should not be delayed with treatment, it is necessary to consult a urologist in time, who will diagnose and prescribe antibiotics.

The inflammatory process of the mucous membrane of the urethra is called urethritis. Symptoms of the disease depend on the form of inflammation, as well as gender. There is an inflammation of the urethra, accompanied by pain during the outflow of urine. Many believe that urethritis is a "privilege" of a strong half of humanity. Nevertheless, this is an erroneous opinion, since both men and beautiful ladies are susceptible to the development of the inflammatory process.

If you are faced with the question of how to cure urethritis, which doctor you need to contact for help, then this information is for you.

1. Ways of infection with urethritis
2. The main symptoms of urethritis

If you experience any discomfort while urinating, seek medical attention. If you do not know which doctor is treating urethritis, then you can go to a therapist who will prescribe an examination, and then send you for a consultation with a urologist. He can prescribe additional procedures to make a diagnosis, as well as identify the causes of urethritis.

It should be noted that the symptoms of urethritis in patients of different sexes manifest themselves in different ways.

Urethritis in women often goes from acute to chronic because women have mild symptoms. Being a carrier of the infection, she may not know about it, presenting the danger of infection to sex partners.

The reason for this is the individual characteristics of the female body. The urinary tract is only a couple of centimeters long. It also differs in the diameter of the lumen. Even with significant swelling, there are no obstacles to the outflow of urine.

The signs of urethritis in the male population are more pronounced, the pathological process can be diagnosed in the early stages. This is a great advantage, as it is possible to start treatment as soon as inflammation is detected. It should also be emphasized that the symptoms and treatment of the disease are interrelated, in each case they are individual in nature.

Ways of infection with urethritis

Inflammation of the urethra occurs when pathogenic microorganisms get inside: bacteria, fungus or virus.

To date, doctors have identified two ways of infection through which the infection can enter the body: sexual contact, household or hematogenous.

What does it mean:

1. During sexual intercourse, urethritis is transmitted from man to woman due to unprotected intercourse, that is, without the use of condoms. Oral contraceptives are powerless against sexually transmitted infections, as their main task is to prevent conception.
2. The hematogenous pathway involves the introduction of the virus through the bloodstream or lymph. Infection can occur if there are injuries or microcracks in the skin and mucous surfaces. Also, with urethritis, carious teeth, ulcerative lesions of the oral cavity, tonsillitis or chronic sinusitis, diseases of the upper respiratory or digestive system are considered as the cause.
3. Sharing personal hygiene items: towels, washcloths can be identified as a route of infection.

Before treating urethritis, you need to identify the cause of the development of the disease, the severity and make appropriate appointments. A little further, the forms of the disease will be considered, their signs depending on the type of pathogen. It should be noted that some types of ailment are transmitted only through sexual contact.

What is the reason for the activation? What are the characteristics of this microorganism?

Let's dwell on each of them separately:

1. On the basis of the pathogen, the pathology is divided into infectious, non-infectious urethritis in men or women. Also, the infectious form of pathology differs: specific and nonspecific. Specific urethritis develops against the background of damage by viruses, bacteria. The nonspecific form is characterized by a purulent etiology. May be the result of streptococcus, staphylococcus, E. coli. A competent treatment regimen for urethritis involves identifying the exact type of causative agent of the infection, which is necessary for choosing a method of therapy.
2. Also, the phenomenon of an infectious process of viral genesis is observed when the genitourinary system is affected by herpes viruses of the 2nd type (genital) or genital warts. Primary infection has pronounced symptoms of urethritis, after which the virus goes into a latent state. A repeated exacerbation is observed in 75 cases out of 100.
3. With frequent change of sexual partners, especially if intimate meetings are classified as unsafe, the infection can be transmitted between partners.
4. Failure to comply with basic rules of personal hygiene also contributes to the penetration of the virus. Here we can note the sharing of personal hygiene items.
5. Diseases of the pelvic organs. This can be observed against the background of general hypothermia of the body or as a result of a decrease in immunity.

The cause of the development of the inflammatory process can be factors that have nothing to do with various types of viruses and bacteria.

The main causative agents of the disease are:

1. Mechanical damage. Often with urolithiasis, small stones leave the body through the urethra. Given that their edges can be pointed, damage to the mucous membrane of the urogenital organ is often observed. This can cause the development of the inflammatory process. Before treating urethritis, you need to inform your doctor about the presence of urolithiasis.
2. Neoplasms in the urethra of malignant etiology are also the cause of inflammation.
3. Traumatic urethritis is activated when a catheter is inserted, after a cystoscopy procedure, and if mechanical damage has been intentionally inflicted.
4. Allergic reactions.
5. Stagnation of blood in the vessels of the small pelvis.
6. The first experience of intimacy.
7. Hormonal disruption, which can be caused by: pregnancy or its termination, withdrawal of oral contraceptives, menopause.
8. Disruption of metabolic processes.
9. The reason for the inflammation of the urinary tract can be the peculiarities of the diet. With frequent use of salty, spicy, smoked food, irritation of the walls of the organ occurs.
10. A significant role in the development of the disease is played by the use of a large amount of alcoholic beverages that are not always of good quality. Treatment of urethritis involves giving up alcohol, given the incompatibility of many drugs with strong drinks.

The main symptoms of urethritis

In some forms of urethritis, the symptoms of the disease can go unnoticed without causing any discomfort.

There are three stages of the disease:

1. Acute urethritis. Inflammation of the anterior region is characterized by abundant discharge from the urethra, reddening of the flesh, and swelling. There is pain on palpation. There is an increase in urination, accompanied by cramps and burning. The first portion of urine is cloudy, the sediment quickly settles to the bottom of the vessel.

The defeat of the posterior canal is characterized by the frequency of diuresis, a decrease in the volume of secretions. Blotches of blood may appear. Resis are noted at the end of the process.

In the acute form of urethritis, treatment involves the appointment of pain relievers.

1. Torpid. Itching, redness is noted. Purulent discharge is absent, there may be a sensation of sticking of the foreskin of the urinary tract. Feelings of discomfort. Small threads are present in the urine.
2. Chronic. There are no pronounced signs. Only with an exacerbation of the pathological process can characteristic symptoms appear.

The incubation period from the moment of infection appears after 5 days to several months. There are individual cases when this period was reduced to several hours.

Also, pathology itself can act as one of the symptoms of a disease. This can be caused by metabolic disorders or the development of a chronic form. When the disease is neglected, complications of urethritis are observed.

Summing up, the main symptoms of the disease can be distinguished:

1. Acute urethritis. It is accompanied by painful sensations, cramps during urination, itching, burning.
2. There is a sensation of sticking together the outer edge of the urinary tract. Reddening of the flesh is also observed.
3. Discharge of a purulent etiology of a yellow or greenish tint is noted.
4. The discharge has an unpleasant odor.
5. Painful sensations are transmitted to the genital area: in women, these are the labia, and in men, the head of the penis.
6. Frequent urination.
7. Laboratory analysis of urine shows an increase in leukocytes in the biomaterial.
8. Impossibility of sexual intercourse due to pronounced pain.
9. Urethritis in women is accompanied by pulling pains in the lower abdomen.
10. Often, viral urethritis is accompanied by the simultaneous development of cystitis, which may indicate an intoxication of the body.

As already noted, a group of infectious inflammations of specific and nonspecific genesis is distinguished separately. The type of pathogen, characteristic symptoms are given in a separate table. The diagnostics carried out with urethritis will allow to identify the cause of the pathology, based on the patient's complaints, as well as on the characteristic symptoms of the manifestation of the disease.

Group of urethritis	Causative agents of the inflammatory process		Typical symptoms
Specific	Urogenital tuberculosis		General weakness. Low-grade fever for a long time. Increased perspiration.
	Gonorrhea		The incubation period ranges from 3 days to a couple of weeks. The acute stage is accompanied by pain and cramps during urination. If there is a delay in diuresis, then there is soreness inside the urethra, discomfort. Discharge profuse, purulent, yellow-gray tint. Inflammation of the posterior region is accompanied by an increase in temperature to 39 °. Intoxication of the body is noted. In the chronic stage, the characteristic signs are poorly expressed. Allocations persist in the morning, rather scanty. There is a difficulty in the outflow of urine, which provokes a blockage of the ducts. May cause the development of an abscess.
	Trichomonas		Symptoms appear 1-2 weeks after infection. No specific signs. There is a mild itching and burning sensation of the genital area. Foamy discharge of a pale shade is observed. In chronic forms, there are no obvious signs of pathology.
	Gonococcal		The first symptoms may appear within a few hours after infection. Purulent discharge of a yellow or greenish tint is noted. Acute urethritis is accompanied by swelling, itching, burning. Frequent urination. Increased body temperature.
Nonspecific	Bacterial	Mycoplasma	It begins subacutely, although it has no pronounced symptoms. There is slight itching and discomfort during diuresis. Detection of a certain amount of mycoplasma is considered to be the norm.
		Ureaplasma	The incubation period can last up to 2 months. Symptoms are mild. May accompany other types of urethritis.
		Gardnerella	The incubation period lasts 1-5 weeks. There are no characteristic symptoms. Itching and burning are often observed, as well as scanty gray discharge with a characteristic "fish smell". A mixed form of infection with the presence of yeast-like fungi is more common.
	Viral	Condylomatosis of the urethra	Characterized by papillomatous formations on the head of the penis in men or in the vagina in women.
	Chlamydial	Chlamydia	The first 20 days there are no symptoms of the disease. Subsequently, there is a slight itching, slight pain when urinating. Discharge of purulent etiology. Some cases are marked by articular damage, as well as inflammation of the conjunctiva.
	Mycotic	Candida	Most often, this type of ailment is noted as a complication after prolonged antibiotic treatment. Soreness and discomfort appear within 3 weeks from the moment of infection. There may be mild cramps or burning sensation when urinating. Discharge is scanty. They have a viscous consistency. Typically a pale pink hue.
	Mixed infection	Trichomonas	A discharge of white or green color, followed by a crust at the end of the penis. More often celebrated in the morning. Itching, burning when urinating.
	Transient short-term	Spread of urogenital infection from the urethra to the prostate gland	The infection is observed to spread up towards the prostate gland. Symptoms are typical for all forms of the pathological process.

Diagnosis of urethritis is carried out using various research methods. Treatment of urethritis involves an integrated approach to solving the problem.

Ornidazole 1.5 g orally once;

An increase in the number of segmented neutrophils in Trichomonas infection occurs due to damage to the epithelium. The defeat of the epithelium leads to the release of inflammatory mediators (serotonin, histamine). Due to these substances, the links of the immune system are launched, aimed at fighting the infection.

2. derivatives of nitrofuran;

There is no consensus on the duration of the incubation period for trichomoniasis. In the literature available to us, various data are given: from 3 days to 3-4 weeks and even 55 days.

4. Examining your partner can help you get the right diagnosis.

The most widespread, but insufficiently sensitive method for laboratory diagnosis of trichomoniasis is microscopic examination of native or stained preparations. When examining a native preparation, the pathological material is placed in a drop of warm isotonic sodium chloride solution on a glass slide, mixed thoroughly, covered with a cover glass and immediately examined in a microscope with a 40 objective. The best results are obtained by viewing the native preparation in a microscope with a dark-field condenser, since In this case, single and weakly mobile individuals are found in the accumulations of cellular elements due to the clearly visible movement of the flagella. In the native preparation, Trichomonas is characterized by an oval or round shape, the presence of flagella and jerky movements of protozoa.

Desquamated epithelium cells;

Fresh trichomoniasis in women is established by the nature of the vaginal smear. If the result shows a large number of bacteria, an acute form of the disease is traced. With a small number of bacteria, a chronic course, latent carriage can be traced. Along with the urogenital Trichomonas, other components can be traced:

The fresh forms of trichomoniasis should include cases with a disease duration of up to 2 months with pronounced and moderately pronounced inflammatory processes of the human urogenital sphere. Chronic forms of trichomoniasis include sluggish cases of the disease (more than 2 months or if the timing of the onset of the disease is unknown). Trichomoniasis should include cases when there are no inflammatory reactions in the body, but with sexual intercourse, urogenital Trichomonas are transmitted to healthy individuals, causing them to have a typical clinical picture of the disease.

The first drug regimen... on the 1st day, 2 tablets (0.5 g) three times a day with an interval of 8 hours. Then the daily dose is reduced daily by 1 tablet with the same interval. For the course, the total dose is 3.75 g for 6 days.

Metronidazole

Urogenital trichomoniasis is a widespread sexually transmitted infectious inflammatory disease caused by protozoa Trichomonas vaginalis .

Control of partner infection;

Nitroimidazole derivatives are synthetic antimicrobial drugs that are used to fight infections caused by anaerobic bacteria and protozoa. The first drug in this group was metronidazole, which has been used since 1960.

Metronidazole (trichopolum, flagil, clion)... Has a pronounced effect on urogenital Trichomonas. An important feature of this remedy is its activity when taken orally; the drug is rapidly absorbed and accumulates in the blood in concentrations that are detrimental to Trichomonas. Metronidazole is widely used to treat acute and chronic trichomoniasis in men and women. The drug is available in tablets of 0.25 and 0.5 g and in the form of vaginal suppositories and tablets of 0.5 g.

The clinical picture of diseases of the genitourinary organs caused by chlamydia differs from gonococcal infection mainly by a lesser severity of the inflammatory process, a high frequency of complications and resistance to therapy. For women, chlamydia poses the greatest danger, since it causes not only a serious pathology of the lower genitourinary system, but is often accompanied by the development of an ascending disseminated infection, the occurrence of pelvic inflammatory diseases, the development of infertility, and infection of newborns. Most often, and above all, chlamydia infects the cervix, from where, as from a reservoir, the process spreads to the urethra, uterus and fallopian tubes, to internal organs. The incubation period for chlamydia ranges from 15-30 days.

Trichomoniasis - what is it

Direct isolation from the patient's tissues (bacteriological method). Bacteriological studies suggest the identification of chlamydia in the affected cells (clinical material).

Principles of Trichomonas treatment

Metronidazole- vaginal balls (tablets) of 0.5 g are prescribed once a day intravaginally for 6 days.

Leukocytosis;

Fresh trichomoniasis: a) acute; b) subacute; c) torpid;

In practice, some doctors have developed a step-by-step treatment for mix infections. Initially, therapy is aimed at eradication of Trichomonas. At the second stage, antibiotics are prescribed against the accompanying flora. This approach is not justified. Antibacterial agents are toxic to the body. With the wrong dosage, chronic infection occurs. True, the course of nosology depends on the state of the patient's immunity. In one person, under the influence of medications, immunoglobulins, antiseptics, complete sterility is observed. In others, several types of bacteria develop antibiotic resistance, and the disease becomes chronic.

Trichomoniasis treatment: basic principles

Note!

The main lesions in urogenital trichomoniasis are the urethra in men, the vagina and urethra in women. In women, the large vestibular and paraurethral glands and the cervix may be involved in the inflammatory process. Trichomonas are found in the uterine cavity, in sactosalpinx, ovarian cysts. There are reports of a connection between urogenital trichomoniasis and complications of pregnancy (premature birth, early rupture of the fetal bladder, etc.). The clinical picture of uncomplicated urogenital trichomoniasis in women is characterized by the presence of an inflammatory process in the vagina and the vaginal part of the cervix. In the future, vestibulitis, paraurethritis, endocervicitis, endometritis, etc. may join, which is considered as a complicated course of the disease.

Methods of serological diagnosis of chlamydia are based on the determination of specific antibodies in the blood serum, as well as in the secrets of persons who are sick or have a history of chlamydia. The interpretation of the results of serological examination should be carried out in conjunction with the analysis of clinical and epidemiological data, as well as taking into account the characteristics of the serological test used.

2. Is it possible for a false positive smear result when examining men.

Antioxidants

Treatment of urogenital chlamydia

Staphylococcus aureus.

The main drugs for the treatment of trichomoniasis are:

Torpid (lasting more than 2 months).

With fresh uncomplicated Trichomonas lesions, there is no need for local treatment, since there is enough generality to eliminate inflammation. With torpid fresh inflammatory processes and chronic forms of trichomoniasis, local treatment is prescribed. Topical drugs are used simultaneously with general action protistocidal drugs.

Immunomodulators;

Coccal flora.

Klion D (metronidazole)

These agents act on microorganisms by disrupting their tissue respiration, as well as protein synthesis and replication of genetic material. All this allows them to have a bactericidal effect, that is, directly cause the death of bacteria and protozoa.

Ornidazole 500 mg orally 2 times a day for at least 10 days;

Elimination of alcohol;

Clacid (clarithromycin). In uncomplicated forms of chlamydia, 250 mg is prescribed twice a day for 7 days, in chronic - 12-14 days, 400 mg once a day.

Streptococcus;

There are several morphological varieties of the microbe. Throughout the life cycle, the pathogen has the following types:

After the basic course, supportive therapy is prescribed with the following means:

3. derivatives of nitrothiazole;

Sumamed is not effective against Trichomonas.

Atrikan (tenonitrozole)

How and how to properly treat trichomoniasis

Gonococcus;

Immunostimulants.

Tetracycline drugs, macrolide antibiotics, rifampicin, josamycin, and fluoroquinolones have an etiotropic effect against chlamydial infection. For etiotropic therapy, courses of treatment lasting from 7 to 14 days are used. For uncomplicated infection in men and women, treatment should be given with an antibiotic. With sluggish torpid forms of infection, treatment, as a rule, should be comprehensive. When treating such patients in a hospital, the appointment of an antibiotic should be preceded by immunotherapy and local treatment. On an outpatient basis, in order to prevent the spread of infection, an antibiotic is prescribed simultaneously with immunotherapy (polyoxidonium or cycloferon), followed by local treatment. When treating pregnant women, erythromycin is prescribed 0.5 g orally after meals every 6 hours for 7 days.

When carried, sulfonamides do not have a pronounced therapeutic effect. The most popular drug is metronidazole (trichopolum). Anaerobic cocci, which are often an accompanying flora in Trichomonas infection, are resistant to this drug.

MedCollegium www.tiensmed.ru answers:

Pefloxacin (abactal). With fresh uncomplicated chlamydia, 600 mg is administered orally once a day for 7 days. With chronic - within 10-12 days.

Foamy discharge

Laboratory diagnostics

Etiological drugs (imidazoles);

Both partners are ill even if one of them does not have microorganisms;

2. Gardnerellosis and candidiasis are essentially vaginal dysbiosis. Moreover, they often change each other. For more details, see the articles Candidiasis and Gardnerellosis

Klion D (metronidazole)- vaginal tablets for 0.1 5 days.

With successful treatment with antibacterial agents, therapy continues with antioxidant drugs.

Drugs prescribed for basic treatment:

Nitrofurans are synthetic antimicrobial agents that are used to treat uncomplicated urinary tract infections, intestinal infections, and infections caused by protozoa, including Trichomonas.

The species Ch.trachomatis unites microorganisms that cause diseases mainly in humans (anthroponous chlamydia). Ch.trachomatis pathogenic for humans are divided into three biovars: causative agents of lymphogranuloma venereum; causative agents of hyperendemic trachoma; causative agents of sporadic eye diseases (paratrachoma, conjunctivitis with inclusions in newborns and adults) and urogenital chlamydia (urethritis, cervicitis, salpingitis, proctitis, prostatitis, epididymitis, pneumonia of newborns)

A commonly used serodiagnostic method is the indirect immunofluorescence antibody test (NIF). During the NIF, fixed purified chlamydial antigens are used, applied in the form of dots on the glass. The applied patient serum reacts with antigens of various serotypes, after which it is treated with an anti-species luminescent serum. The test is sensitive, in many cases it gives information about the chlamydia serotype; it is advisable to use it in epidemiological studies.

Serologic tests that detect antibodies.

Nitrofurans are used to treat chronic Trichomonas infection, as well as when therapeutic regimens using drugs from the group of nitroimidazole derivatives are ineffective.

Tinidazole (fasizin, triconidazole, etc.). The structure and action is close to metronidazole. Assign orally in tablets of 0.5 g. Scheme of taking tinidazole: 1) once in a dose of 2 g (4 tablets); 2) 0.5 g every 15 minutes for 1 hour. Contraindications are the same as for metronidazole: 1st trimester of pregnancy and the period of breastfeeding, hematopoiesis disorders, active diseases of the central nervous system. During treatment, you should not take alcoholic beverages. Blood tests should be done before and during treatment.

metronidazole 500 mg 3 times a day for 12 days;

An ascending infection of the urinary tract and kidneys (cystitis, pyelitis, pyelonephritis) may develop. Complications with Trichomonas urethritis in men are more common than with gonorrhea. The clinical picture of Trichomonas prostatitis, vesiculitis, epididymitis differs from that of gonorrheal etiology, which proceeds, as a rule, more violently. With a protracted course, the formation of single or multiple urethral strictures is possible. In girls, urogenital trichomoniasis occurs with damage to the vulva and vagina.

The result of treatment should be assessed by laboratory control tests, and not by the disappearance or weakening of symptoms.

Mixed Trichomonas infection is treated for a long time due to the increased resistance of microorganisms to the influence of pharmaceuticals.

Urogenital Trichomonas are of three forms: pear-shaped, amoeboid and budding; the latter is less common than others. The pear-shaped form is considered the main one, and the rest are intermediate stages of the life cycle of Trichomonas, they are unstable outside the human body. A prerequisite for their viability is the presence of moisture; when dried, they quickly die. These protozoa are also unstable to many other environmental factors: an increase in temperature over 40 ° C, direct sunlight, a change in osmotic pressure, exposure to antiseptics, etc.

nimorazole 500 mg orally 2 times a day for 12 days;

Yellow, frothy vaginal discharge. The nature of the secret depends on the severity of the pathological process. A small amount of mucus appears in the chronic course of nosology;

Acetate.

Nitroimidazoles can cause a number of side effects such as bad taste in the mouth and nausea. diarrhea. headache. allergic reactions, etc. It should be noted that during the use of drugs of this group ( excluding ornidazole) the use of alcoholic beverages is strictly prohibited. This is due to the fact that these funds block the enzyme acetaldehyde dehydrogenase, which leads to a violation of the breakdown of alcohol and causes the accumulation of acetaldehyde, which is toxic and can cause a number of side effects.

Decrease in intracellular glycogen.

Nifuratel. When treating a fresh infection, Nifuratel should be taken at a dose of 200 mg 3 times a day for 2 weeks. For chronic infection, the dose is increased to 400 mg. Nifuratel is a first-line drug from this group, as it has the least number of side effects.

Ornidazole has a unique feature - it can be used in patients who cannot stop drinking alcohol. The drug does not affect the metabolism of ethyl alcohol.

Trichomoniasis should be classified according to the localization of inflammation.

Torpid;

Solkotrikhovak- 0.5 ml intramuscularly, three injections with an interval of 2 weeks, then 0.5 ml once a year later. If indicated, it is recommended to prescribe pathogenetic and local therapy. The criteria for the cure of genitourinary trichomoniasis are established in 7-10 days after completion of treatment using microscopic and cultural research methods.

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Direct visualization of the agent in clinical samples during staining (bacterioscopic method). Bacterioscopic studies involve the identification of the morphological structures of chlamydia in the affected cells (clinical material).

Total questions on the topic - 55

Fresh trichomoniasis downstream is classified into torpid, subacute, acute. In the chronic course, several forms are distinguished, depending on the frequency of exacerbations:

Chlamydiae are allocated in a separate order Chlamydiales, including one family Chlamydiaceae, containing one genus Chlamydia, consisting of four species: Ch.trachomatis, Ch.psittaci, Ch.pneumoniae, Ch.pecorum

What to do if trichomoniasis therapy is ineffective:

Trichomonas carriage.

Sloughing of cells;

In women, the incubation period of the disease is 10 days. In men, it lasts more than a month. Symptoms of urogenital urethritis in the strong half rarely occur acutely.

Important principles of therapy for Trichomonas infection;

All pills have a negative effect on the fetus;

Lactate;

tinidazole 2.0 g orally once.

DO NOT TREAT YOURSELF, CONTACT A DOCTOR!

Methods of laboratory diagnosis of urogenital chlamydia

The bacterium is large - up to 10 microns long, up to 7 microns wide. The causative agent is able to change its shape according to the state of the external environment. Under unfavorable conditions, the bacterium becomes oval. The usual form is amoeba.

Urogenital Trichomonas, which fell on the mucous membrane of the urethra during intercourse, stay in the first 12-24 hours on the surface of the scaphoid fossa lined with squamous epithelium. Reproducing, they spread like ivy on the surface, but do not penetrate into the slits of the squamous epithelium. In response to an invading infection, active hyperemia appears, which is expressed in swelling and redness of the sponges of the external opening of the urethra, and subjectively, the patient feels itching and slight tickling. As the urogenital trichomonads multiply and spread along the mucous membrane of the urethra, they reach the places lined with the cylindrical epithelium in about 24-36 hours.With the involvement of the cylindrical epithelium in the inflammatory process, serous fluid seeps through the walls of the vessels, which loosens the connection between epithelial cells and connective tissue ... The normal state of the vascular walls is disrupted, abundant migration of leukocytes begins with their infiltration of the upper layers of the subepithelial tissue.

The main drugs for the treatment of trichomoniasis are:

Directed antibacterial agents are prescribed after sowing vaginal secretions (in women) or scraping from the urethra (in men). Before bacteria are detected, antibacterial agents of a wide spectrum of action (imidazoles) are prescribed.

With prolonged Trichomonas infection, other diseases occur:

Local treatment. With fresh uncomplicated Trichomonas lesions, there is no need for local treatment, since there is enough generality to eliminate inflammation. With torpid fresh inflammatory processes and chronic forms of trichomoniasis, local treatment is prescribed.

For fresh trichomoniasis, the following schemes are used:

A feature of the clinical course of the inflammatory process in chlamydia of the genitourinary organs is asymptomatic and malosymptomatic course, multifocal: urethritis, epididymitis, oophoritis, prostatitis, vulvovaginitis, proctitis, colpitis, cervicitis, endocervicitis, salpingitis, parametritis, septic conditions The acute form of chlamydia with profuse discharge, pronounced hyperemia of the mucous membranes, with dysuric disorders and severe pain is rare even in men, and in women only in exceptional cases. Subacute and torpid forms are much more common. In men with chlamydia, the examination reveals moderate hyperemia and swelling of the sponges of the urethra, sometimes the foreskin of the penis, mucopurulent discharge. In women, chlamydia is manifested by increased pain, pain in the lower abdomen and in the sacrum during and after intercourse, pain during urination can be noted. The disease often proceeds without subjective sensations and with minimal or no clinical manifestations.

Question: What antibiotics should be taken for trichomoniasis?

Itching of the genitals with urination;

Josamycin (Wilprafen). In uncomplicated chlamydia, 500 mg is administered orally for 7 days every 12 hours; for a course of 7.0 g.

Of great practical importance is the question of the classification of trichomoniasis. In order to prescribe the correct treatment, the classification, as in gonorrhea, is based on the intensity of the body's reaction to the introduction of urogenital Trichomonas, which is reflected in the clinical manifestation of the disease. From this point of view, it is advisable to distinguish between the following forms of trichomoniasis.

The drugs of first choice are azithromycin and doxycycline. The high efficacy of doxycycline in chlamydial infection and its low cost retains its priority in the treatment of urogenital chlamydia.

Urogenital chlamydia is one of the serious medical and social problems. The specified infection has become widespread in various countries of the world, and the number of infected is constantly growing.

3. If I understand correctly, the leukocytes in the second smear are inflammation, again from where?

For local treatment, instillation of the urethra with a 0.25-0.5% solution of silver nitrate is also used every other day with a 2% solution of protargol or 1% solution of collargol.

The diagnosis of urogenital trichomoniasis is established upon mandatory detection T.vaginalis by laboratory research. For laboratory diagnosis of trichomoniasis, scopic methods and culture research are used. Due to the common routes of infection, urogenital trichomoniasis is often combined with other sexually transmitted diseases, and therefore patients should be subjected to appropriate examination. In the case of concomitant urogenital infections (associations), their treatment is carried out simultaneously.

Clindamycin

3. We must look for the reason

Penetrating into the urogenital tract, bacteria provoke the development of the inflammatory process. In practice, specialists meet with inflammatory changes in the vagina, an increase in the number of polymorphonuclear neutrophils.

Check the sexual partner;

Furazolidone. Furazolidone is taken at a dose of 100 mg 4 times a day for a week with a fresh infection, and within two weeks with a chronic one. When using it, you should avoid the use of antidepressants ( from the group of MAO inhibitors), as well as alcohol, as this can cause a number of unpleasant side effects.

Candidate of Medical Sciences

Doxycycline is prescribed at 300 mg at the first dose, and then at 100 mg every 6 hours. The total dose for the treatment of uncomplicated trichomoniasis should be 500 mg, and 1 gram for the treatment of complicated trichomoniasis.

In patients with urogenital chlamydia, especially with prolonged, recurrent course, repeated or irrational use of antimicrobial drugs, violations of the intestinal microbiocenosis are revealed, which in turn negatively affects the course of physiological processes and the reactivity of the body.

4. tetracyclines.

Trichomoniasis is a multifocal infection. List of organs that are affected by Trichomonas:

Symptoms of urogenital trichomoniasis occur due to the multifocal lesions of the paraurethral passages, cervix, and vagina. Cases of Trichomonas salpingitis, urethritis are accompanied by bacterial infection of internal organs.

According to the second scheme appoint 0.25 g twice a day with an interval of 12 hours; this scheme provides for the additional administration of 1 vaginal suppository or tablet containing 0.5 g of metronidazole. The drug is used internally and topically for 10 days. If necessary, repeat the course of treatment in a month.

With light microscopy, granules are visualized inside the cytoplasm.

The main symptoms of Trichomonas infection in women:

5-nitroimidazoles.

The symptomatology of chlamydial diseases in children is more pronounced and, depending on the duration of the inflammatory process, manifests itself in the form of vulvovaginitis, urethritis, cervicitis. More often girls are sick, especially at an older age, when infection occurs through sexual contact. Along with diffuse hyperemia of the vulva and adjacent areas of the skin, there is edema of the external genital organs, their maceration as a result of abundant, liquid gray-green discharge. If the urethra is damaged, the sponges are hyperemic, edematous, covered with gray discharge, possibly frequent and painful urination.

The "fresh" form has the following varieties:

The most common causative agent of trichomoniasis is Trichomonas vaginalis. The bacterium is sexually transmitted. Severe clinical symptoms of infection are rare. Pathology is diagnosed by chance - during a gynecological preventive examination of a woman. It is difficult to identify trichomoniasis in men due to the rare visit to the urologist, therefore, carriership is common among the representatives of the strong half.

Trichomonas carriage is common in men. The latent course of infection leads to the development of resistance of microorganisms against antibacterial agents.

Nitrofuran derivatives.

The inflammation is accompanied by a low-grade fever. An increase in segmented leukocytes occurs due to the destruction of the epithelium of the genital tract. The microorganism secretes hyaluronidase - an enzyme that destroys connective tissue fibers, cartilage tissue. The action of the substance contributes to the looseness of the vagina, cervix.

In men, Trichomonas can cause damage to the prostate gland, seminal vesicles, epididymis, Cooper glands.

Urogenital trichomoniasis is a multifocal disease in which urogenital trichomoniasis can be localized in all urogenital organs.

Vestibulitis;

Treatment of pregnant women. Treatment is carried out with metronidazole (excluding the 1st trimester of pregnancy) at a dose of 2.0 g orally once.

Metacyclin (rondomycin). In acute and uncomplicated forms, it is prescribed orally after meals at a dose of 600 mg (first dose), then 300 mg every 8 hours for 7 days, for a course of treatment of 6.6 g. In other forms, the course of treatment is extended to 10 days.

Proteolytic enzymes;

Flagellar carrier;

Nitrothiazoles are synthetic antimicrobials. A representative of this group, aminitrozole, has a pronounced activity against protozoa.

Consider the principles of stepwise therapy for Trichomonas infection. Preparations used at the preparatory stage:

A month ago, I was diagnosed with gardnerellosis. Smear results: vagina leukocytes - 0-0.1, cervix 10-15, Trichomonas, fungi, no gonococci, aerobic microbes (bacilli + cocci) - very abundant, anaerobic microbes Gardnerellae vaginalis - cytogram of bacterial vaginosis. Treatment: trichopolum (1 tablet 3 times a day for 7 days) and betadine. Smear after treatment: vagina leukocytes - 5-10, cervix 40-50, Trichomonas, gonococci, Gardnerellae vaginalis no, aerobic microbes (bacilli) - abundant and Candida fungus appeared. There are no complaints (itching, discharge). The doctor suspects trichomoniasis, they took blood for antibodies to Trichomonas and chlamydia and a smear for bacterial culture. They also told the partner to be examined (blood for antibodies, smear and sperm for tank culture) and if they find an infection in one of us, they will treat both of us. Actually, the questions:

The most effective in relation to vaginal Trichomonas are the following drugs:

Carbon dioxide;

Tetracyclines.

In pregnant women with chlamydia, complications are more often observed: urgent labor, premature birth, undeveloped pregnancy, spontaneous miscarriage. It is generally accepted that a newborn in 40-50% of cases acquires chlamydial infection during childbirth due to infection with pathological material when passing through the birth canal of a mother with chlamydia (chlamydia was isolated in newborns from the conjunctiva, nasopharynx, middle ear, trachea, lungs, rectum, etc. vagina), but it is also possible for infection to enter the amniotic fluid and intrauterine infection of the fetus.

The cultural method for diagnosing trichomoniasis is more reliable and sensitive than microscopic examination. To a greater extent, its effectiveness depends on the quality of the nutrient media used. The composition of the proposed media with high growth properties includes meat-peptone broth (MPB), liver preparations, mineral salts, sugars, human or animal blood serum, hydrochloric acid cysteine ​​and other ingredients.

Trichomoniasis is provoked by the following types of microorganisms of the flagellate family:

Tinidazole.

When taken orally, nitrofurans are well absorbed from the gastrointestinal tract. They are excreted from the body quickly and therefore are not able to create high concentrations in tissues.

Increasing the body's resistance;

Trichomonas tenax (elongata);

In order to detect vaginal Trichomonas in stained preparations, numerous staining methods are used, in particular methylene blue, gentian violet, according to the methods of Gram, Romanovsky-Giemsa, Leishman-Romanovsky, etc. The widespread use of methylene blue is due to the fact that it is also used for staining smears on gonococcus. The study of stained smears allows you to determine the morphology of the pathogen, smears do not require immediate research, which is especially important in a mass examination for trichomoniasis. However, diagnostic errors are possible, since epithelial cells can be mistaken for Trichomonas.

1. 5-nitroimidazole derivatives;

Trichomoniasis

When taking nitroimidazoles with alcohol, you may experience:

Symptoms of trichomoniasis in men and women

The cavities of the glands and excretory ducts are filled with leukocytes and multiplying urogenital Trichomonas.

Solkotrikhovak- 0.5 ml intramuscularly, three injections with an interval of 2 weeks, then 0.5 ml once a year later.

1. The doctor suspects that the increased number of leukocytes in the cervix may be due to trichomoniasis. In my opinion, you are unlikely to have trichomoniasis, since you received trichomoniasis during the treatment of gardnerellosis.

Trichomonas hominis (abdominalis).

metronidazole 2.0 g orally once;

With Trichomonas, clinical symptoms rarely occur. Rare exacerbations are eliminated according to the following principles:

Be sure to adhere to the diet, the dose of drugs;

Salpingitis.

Microorganisms belong to the Trichomonadidae family, the Trichomonas genus, the Protozoa kingdom.

Hepatoprotectors.

Urethritis;

The criteria for the cure of genitourinary trichomoniasis are established in 7-10 days after completion of treatment using microscopic and cultural research methods.

Local dosage forms do not cure the disease.

Tetracyclines are antibiotics... which are widely used in medical practice. However, due to the emergence of a large number of resistant bacteria, their use is somewhat limited.

The basic principles for diagnosing chlamydial infection are the same as for other bacterial pathologies. Test procedures include the following:

Urogenital chlamydia, urogenital trichomoniasis

Loosening of the tissue is provided by the cellular uncoupling factor. Subendothelial penetration is carried out by the enzymatic apparatus. The urogenital form of the pathogen is able to resist the influence of immune components.

Trichomoniasis symptoms are not expressed. Infection does not lead to the development of persistent immunity. Secretory, serum antibodies are a sign of previous infection. They form a weak immune system. They remain in the blood for a year after the disease.

Redness of the uterus ("strawberry neck");

1. Treat any form;
2. Carriage.

Lomefloxacin (Maxaquin). With a fresh, uncomplicated form of chlamydia, 600 mg is recommended once a day for 7 days, with a chronic form - within 10-11 days.

When studying native drugs, one should remember about the possibility of flagellate protozoa of the bodonid family in the urine. Unlike Trichomonas, they are smaller and have only two flagella, which determines their rapid forward motion in a straight line. The presence of leukocytes in the preparation in combination with a large number of well-movable rods attached to them can also lead to errors in the recognition of Trichomonas.

3. Salpingitis;
4. Ornidazole;

Under the influence of urogenital Trichomonas, the epithelium of the urethra is injured, degenerates; the interconnection between cells and their nutrition is disrupted, the epithelium sloughs off up to the formation of erosions and ulcers. The latter arise due to the action of protozoan proteolytic enzymes on epithelial cells and subepithelial tissue. The mucous membrane of the urethra swells, thickens, loses its elasticity, bleeds easily.

Metronidazole appoint to children aged 1 to 5 years orally 1/3 tablet containing 250 mg, two to three times a day; 6-10 years old - 0.125 g twice a day; 11-15 years old - 0.25 g twice a day for 7 days.

5. The use of alcoholic beverages during treatment is prohibited;

Local treatment of trichomoniasis

Treatment trichomoniasis... according to the latest recommendations of the world health organization, it should be carried out with drugs from the 5-nitroimidazole group ( metronidazole. tinidazole, etc.), since they are most effective against the causative agents of this infection. However, in some cases, it is possible to use other antimicrobial drugs.

For complicated and chronic trichomoniasis, the following schemes are used:

6. Subacute;

4. Is it obligatory for a partner to be examined if he recently had smears and no infections were found in him?

7. Escherichia coli;
8. Vitamins;
9. Urethra.

L. A. Bokalova

10. tinidazole 2.0 g per day every other day in a total dose of 6.0 grams.

Therapy of diseases of the urinary tract organs caused by chlamydia is based on the use of drugs that are active against this microorganism. At the same time, the biological characteristics of chlamydia should also be taken into account. They have not only a high tropism for the epithelial cells of lesions, but also persist in special membrane-limited zones of the epithelium, which is a prerequisite for the pathogens to survive the period of drug therapy. This may be associated with failure in treatment, as well as the possibility of the transition of the disease to an asymptomatic and latent state. Therefore, in the course of treatment, not only etiotropic, but also pathogenetic agents are used. All persons who have chlamydia, regardless of the severity of the clinical picture, are subject to treatment; it is also advisable to treat their sexual partners. In all cases, the therapy of this infection, regardless of the technique used, involves the prevention of the development of candidiasis, including the use throughout the entire course of therapy of nystatin and levorin in a daily dose of 2 million units or nizoral 0.2 g twice a day or pimafucin according to 0.2 g twice a day.

Currently, domestic experts have not come to a consensus regarding the classification of chlamydia. Some of them use a classification similar to that adopted for gonorrhea, others are arbitrary, in accordance with the localization of lesions or the nature of the course of the infection. It is advisable to use the term "urogenital chlamydia" when making a diagnosis, which makes it possible to identify chlamydia among sexually transmitted diseases.

• Chronic;

Trichomoniasis can be medically treated with the following drugs:

• Repeated tests one week after the start of therapy.

Topical drugs are used simultaneously with general action protistocidal drugs.

• Cervix;

Classification of trichomoniasis downstream:

1. Why trichomoniasis, if there is no Trichomonas in one or another smear?

DNA diagnostic methods are based on the complementary interaction of nucleic acids, which allows high-precision identification of the nucleotide sequence in the genes of the desired microorganism. Of the numerous modifications of this method, polymerase chain reaction (PCR) and ligase chain reaction should be distinguished as the most widespread.

• Ternidazole;

Clindamycin

For serodiagnostics, the most commonly used enzyme-linked immunosorbent assay (ELISA for the presence of antibodies) is currently used. The general principle of ELISA diagnostics is as follows: the antigen is fixed on a solid surface, treated with the test serum, and then with an anti-species immunoglobulin bound to the enzyme, which is visualized after the addition of the substrate. The advantage of the method is the ability to automatically record the results and identify the classes of antibodies - IgG, IgA, IgM. Given the low immunogenicity of "urogenital strains" of chlamydia and the possibility of the presence of antibodies after a previous chlamydial infection, it is necessary to examine several serum samples in the dynamics of the disease with an interval of 2-3 weeks.

• Dystrophy;

Doxycycline (vibramycin, unidox solutab). For patients with uncomplicated forms of chlamydia, the drug is administered orally: the first intake is 0.2 g, then every 12 hours for 0.1 g. The course of treatment is 7-14 days, for a total of 1.5-3.0 g. A successful combination of the chemical formula ( monohydrate) and dosage form (solutab) makes the drug unidox solutab the safest, and treatment with it is distinguished by the highest compliance among all known doxycycline.

The nucleus of Trichomonas vaginalis is located in front of the cell. The back of the microbe is sharp due to the axostil - a thin thread of hyaline.

• Lactic acid bacteria;
• Fresh;

Some scientific studies have shown that Trichomonas are a source of concomitant infection with other bacteria:

Clinic of urogenital chlamydia

• Pain syndrome in the lower abdomen.

Treatment is carried out metronidazole(excluding the 1st trimester of pregnancy) at a dose of 2.0 g orally once.

During treatment, in order to prevent re-infection, sexual intercourse should be avoided. If this is not possible, use condoms. which are able to provide 70% protection against trichomoniasis.

• You cannot treat an infection without a doctor's prescription;

Local pathological changes in organs with trichomoniasis:

The diagnosis of intestinal dysbiosis is based on the results of bacteriological studies of feces in combination with clinical manifestations, after which drug correction of dysbiosis is carried out.

Treatment, therapy and antibiotics for trichomoniasis

Atrikan (tenonitrozole)- 250 mg twice a day for 4 days.

• Endocervicitis;

2. Where did the fungus come from, if nothing has changed, is the partner the same?

The following antimicrobial agents can be used to treat trichomoniasis:

02/26/2004, Lana, Belarus

Trichomoniasis treatment regimen. Drugs for trichomoniasis

• With multiple cores.
• Determination of specific chlamydial antigens in clinical samples. Bacterioscopic studies involve the detection of chlamydial antigens in the affected cells (clinical material). In routine laboratory practice, you can use both direct (PIF) and indirect immunofluorescence method (NIF). The first method involves processing the drug directly with specific mono- or polyclonal antibodies labeled with fluorescein. When using the second method, the drug is treated first with serum containing unlabeled anti-Chlamydia antibodies, and then with anti-species fluorescent serum.
• Sharp.

1. Determination of antibodies to Trichomonas is not reliable in the diagnosis of trichomoniasis (neither positive nor negative).

Pregnant women are treated starting from the second trimester of pregnancy.

Mixed infection develops due to the ability of Trichomonas to transfer microorganisms to the vaginal neck, incomplete lysosomal fermentation.

Clindamycin- 2% vaginal cream is applied daily for 4 consecutive days.

When analyzing what trichomoniasis is, the ability of the microbe to metabolize chemicals should be stipulated:

• Hormone replacement drugs;

Step-by-step therapy for Trichomonas infection

Urogenital trichomoniasis ranks first among all sexually transmitted infections. The prevalence of the disease in 2001 was about 300 people per 100 thousand of the country's population.

• Discomfort, pain in the perineum during intercourse;
• Take the next course;
• Proliferation of stratified epithelium;

Derivatives of 5-nitroimidazole.

• Local forms;
• Medicines to improve digestion;
• Vulvitis;

Nucleic acid amplification methods

Ornidazole

The first regimen for taking the drug: on the 1st day, 2 tablets (0.5 g) three times a day with an interval of 8 hours. Then the daily dose is reduced daily by 1 tablet with the same interval. For the course, the total dose is 3.75 g for 6 days. According to the second scheme, 0.25 g is prescribed twice a day with an interval of 12 hours; this scheme provides for the additional administration of 1 vaginal suppository or tablet containing 0.5 g of metronidazole. The drug is used internally and topically for 10 days. If necessary, repeat the course of treatment in a month.

Children are treated with the same drugs, taking into account contraindications, in doses determined in accordance with age; more often local procedures are used: sit-down baths from an infusion of chamomile or sage flowers (one tablespoon for one glass of boiling water), or a solution of potassium permanganate twice a day, or douching with the same infusions and solutions, as well as fortifying treatment.

Some authors believe that tetracyclines are active against protozoa, including Trichomonas vaginalis. The main interest is the semi-synthetic drug doxycycline. since he is able to penetrate the Trichomonas cells better than others.

Treatment of pregnant women

• Hidden;

Trichomoniasis is an infectious disease caused by microorganisms of the flagellate family: intestinal (Tr.intestinalis), oral (Tr.tenax), urogenital (Tr.vaginalis) species of Trichomonas.

• Antibiotics;

The combination of dosage forms is determined by the physician. An independent decision regarding therapy can only be made if it is clearly understood what trichomoniasis is, what pathogenesis and biochemical changes occur in urogenital lesions.

Ciprofloxacin (tsiprobay, siflox). In uncomplicated and complicated forms of chlamydia, it is administered orally for 10 days, the first dose is 500 mg, followed by 250 mg each 12 hours later; for a course of 5.0 g.

• Physiotherapy;
• Determination of specific chlamydial genes in clinical specimens.

Venereologist consultation / Trichomoniasis

It is used internally and in the form of local medicines ( among women). Inside, tablets are prescribed in a dose of 100 mg, which must be taken 3 times a day for two weeks. Suppositories, aerosols, suspensions are applied locally.

Drugs in this group are taken orally. Moreover, they are well absorbed from the gastrointestinal tract, and more than 80% of the taken dose enters the bloodstream. These drugs are excreted in the urine, to a small extent in the feces, after metabolization in the liver. If drugs are taken for some time, a cumulative effect may occur, that is, accumulation in plasma and body tissues.

Clindamycin- orally 300 mg twice a day.

Azithromycin (sumamed). In uncomplicated chlamydia, 1.0 g of the drug is prescribed once. In case of a sluggish course, the following scheme for taking sumamed is recommended: 1st day 1.0 g once, 2-3 days 0.5 g each, 4-7 days 0.25 g each, 3.0 g total.

• Secnidazole;

What is trichomoniasis - types of pathogens

Genitourinary trichomoniasis often occurs as a mixed protozoal-bacterial disease with the involvement of many organs of the genitourinary tract in the inflammatory process. In view of this, in the treatment of this disease, it is advisable to use complex therapy. In addition to protistocidal drugs, antibiotics, immunotherapy, vitamin therapy, biogenic stimulants, etc. are used. Local treatment is also widely used: washing and instillation of the urethra, baths and wiping the vagina in women, etc. less than two menstrual cycles. If the source of the trichomoniasis disease is unknown, dynamic medical observation of persons with urogenital trichomoniasis is performed within 6 months with monthly blood tests for classic serological reactions. This period is necessary for the prevention and timely detection of syphilis due to the fact that the drugs used in the treatment of trichomoniasis also have a treponemicidal effect.

Ginalgin- 1 tablet intravaginally for 10 days.

• Nimorazole;

Nitrothiazole derivatives.

In the absence of treatment, after 3-4 weeks, the inflammatory phenomena begin to subside, the discharge stops or is observed only in the morning, after heavy drinking or intercourse. Metaplasia of the epithelial cover of the urethral mucosa occurs: instead of degenerated sloughing columnar epithelium, a stratified squamous epithelium is formed.

Treatment of children

In women, on the background of pathology, ovarian compaction occurs. In men, palpation of the prostate gland produces a purulent secretion from the urethra. The acute course of the disease provokes damage to the kidneys, bladder. Some elderly patients have Trichomonas pyelonephritis.

• Glycerol;

I have such a question: the drug "Sumamed" is suitable for the treatment of trichomoniasis, there it is written in the indications for treatment that it is for Infections of the urogenital tract (gonorrheal and non-gonorrheal urethritis / or cervicitis)

• Persistent immunity helps the eradication of microorganisms, increases the effectiveness of antibiotics;

02/21/2004, Anna, Rostov region

Metronidazole (trichopolum, flagil, clion). Has a pronounced effect on urogenital Trichomonas. An important feature of this remedy is its activity when taken orally; the drug is rapidly absorbed and accumulates in the blood in concentrations that are detrimental to Trichomonas. Metronidazole is widely used to treat acute and chronic trichomoniasis in men and women. The drug is available in tablets of 0.25 and 0.5 g and in the form of vaginal suppositories and tablets of 0.5 g.

27.02.2004, Oksana, Ukraine

• Vagina;
• Bartholinitis;

It is important to note that the treatment of trichomoniasis with any of the listed antimicrobial drugs should be carried out in both sexual partners at the same time. This is due to epidemiological statistics, according to which the detection of trichomoniasis in one of the partners indicates infection in the other. In this case, clinical manifestations may be absent, since an asymptomatic course is extremely characteristic of this disease.

• Latent;

The clinical course of trichomoniasis does not differ from that in inflammatory diseases of the genitourinary organs of a different etiology and often resembles gonorrhea.

Treatment of children. Metronidazole is prescribed to children aged 1 to 5 years orally in 1/3 of a tablet containing 250 mg, two to three times a day; 6-10 years old - 0.125 g twice a day; 11-15 years old - 0.25 g twice a day for 7 days.

Ornidazole- vaginal tablets of 0.5 g are injected into the vagina once for 3-6 days.

Tinidazole (fazigin, triconidazole, etc.)... The structure and action is close to metronidazole. Assign orally in tablets of 0.5 g. Scheme of taking tinidazole: 1) once in a dose of 2 g (4 tablets); 2) 0.5 g every 15 minutes for 1 hour. Contraindications are the same as for metronidazole: 1st trimester of pregnancy and the period of breastfeeding, hematopoiesis disorders, active diseases of the central nervous system. During treatment, you should not take alcoholic beverages. Blood tests should be done before and during treatment.

1. In your opinion, what is the reliability of the blood test for antibodies in the diagnosis of trichomoniasis with a negative result.

The mechanism of action of these drugs is based on their ability to be included in the respiratory chain of microorganisms and disrupt the process of cellular respiration. They also block the synthesis of nucleic acids - the basis of the genetic material of living organisms. At high concentrations, they have a bactericidal effect, at low concentrations, they are bacteriostatic ( inhibit the growth and reproduction of sensitive bacteria).

Recently, more and more data have appeared on the possibility of the existence of latent or persistent forms of chlamydia both in in vitro modeling and in the patient's body in vivo.

• Add the SolcoTrichovak vaccine.

The use of tetracyclines is justified when other antimicrobial drugs are ineffective, as well as when a combined infection of the genitourinary tract occurs, in which microorganisms sensitive to the action of these antibiotics are found.

• Paraurethral passages;
• Trichomonas vaginalis - vaginal (urogenital) Trichomonas;
• According to the statistics of our medicine, women aged 30-50 more often suffer from mastopathy, although recently this disease has also been noted in 14-year-old girls. Cysts are usually formed in women 40 - 55 years old, and fibroadenoma most often occurs in young women 15 - 30 years old. If it is found at an older age, it is considered that the tumor [...]
• In this work, for the treatment of papillomatosis, we used fosprenil, an immunomodulator with antiviral activity, the effectiveness of which has been proven in many viral infections of small domestic animals (2,3). The causative agent of papillomatosis belongs to the group of DNA viruses included in the Papillomaviridae family. These are the smallest of [...]
• For local treatment, instillation of the urethra with a 0.25-0.5% solution of silver nitrate is also used every other day with a 2% solution of protargol or 1% solution of collargol. Yellow-green discharge from the genital tract of a frothy (12%) character. There are the following forms of the disease, depending on the severity of inflammation and its [...]

The modern pharmaceutical industry offers a wide selection of a wide variety of drugs designed to quickly and successfully get rid of urethritis of varying severity. Before the formation of the treatment regimen, the doctor conducts a comprehensive examination of the patient and, on the basis of the laboratory findings, as well as the results of diagnostics, forms the patient's treatment regimen, which includes the most effective medicines belonging to various groups in terms of their pharmacological properties. In this article, we will consider in detail which drugs for urethritis are best suited for both female and male organisms, and also study the characteristics of the most popular antibacterial, antiviral and antifungal drugs that eliminate the inflammatory process in the urethra.

Instructions for the use of drugs and antibiotics for urethritis

The order of taking each medication, which is designed to suppress the pathogenic activity of a bacterial infection, depends on the dosage, properties and type of chemicals that are part of the tablets, intravenous or intramuscular injections. In most cases, if an antibiotic for the treatment of urethritis was prescribed to be taken in tablet form, then on average it is enough to drink 1-2 tablets 3 times a day for 10-12 days. Intramuscular injections can be injected into the patient's body 1-2 times a day for a shorter course of treatment lasting 5-7 days.

Much still depends on the severity of the ongoing inflammation inside the urinary canal, therefore, there is no generalized instruction for all drugs of the antibacterial group and cannot be a priori, because each drug has its own unique chemical or biochemical (if it is made entirely of natural ingredients) formula.

Pills

Most antibiotics for effective treatment of acute or chronic urethritis are available in the form of coated tablets. In practice, the following types of medications have proven their benefits in the fight against infectious microorganisms that provoke inflammation of the urethra.

Azithromycin

It is a semi-synthetic broad-spectrum antibacterial agent. It is effective against microbial urethritis when inflammation in the urinary canal is caused by microorganisms such as Staphylococcus aureus, streptococcal infection, Pseudomonas aeruginosa. Take 2 tablets a day in the morning and in the evening for 10-14 days. Contraindicated in pregnancy and a tendency to various kinds of allergic reactions. The average cost of a package of these tablets in the amount of 10 pieces is 90-110 rubles.

Amoxilav

Belongs to the category of Azithromycin analogs. It is used to treat complicated forms of urethritis, when weaker antibiotics do not bring the desired result. It is taken by patients daily, 1 tablet 3 times a day. The approximate duration of therapy is 10-15 days, and then it is necessary to undergo a second course of treatment to eliminate the risk of relapse. The price of packing Amoxilav will cost the buyer 120 rubles.

Amoxicillin

Contains semi-synthetic penicillin. Amoxicillin tablets were developed to fight bacteria that are naturally immune to traditional penicillin. In most cases, Amoxicillin is used to eliminate foci of inflammation in the urethra, which are caused by Proteus, hospital strains of staphylococcus, and other severe forms of infections. Not prescribed for children under 6 years of age, pregnant women and allergy sufferers. It is taken as prescribed by a doctor, depending on the severity of the disease. The price in a pharmacy is 100 rubles per package.

Biseptol

A universal tablet preparation that destroys most of the bacterial pathogens of urethritis known to science. The positive characteristics of the drug are that it is potent and in a short period of time suppresses most of the microbes, relieving the inflammatory edema of the urethral mucosa. The main disadvantages of drugs are the destruction of beneficial bacteria that live in the intestines, which facilitate the absorption of food.

Wilprafen

A potent antibiotic included in the composition of essential medicines by the World Health Organization. Refers to the macrolide group. Acts on the inflamed urinary canal pointwise, does not cause a large number of side effects. It is taken no longer than for 10 days, and then it is necessary to take a break so that there is no addiction. The cost of one pack of Volprafen is 580-600 rubles.

Doxycycline

Kanephron

Natural medicine made on the basis of extracts from leaves and rhizomes of medicinal herbs. Available in the form of liquid tincture tablets.

It is taken 2 times a day, 10 minutes before meals, 1 tablet. It has anti-inflammatory and antiseptic properties on all organs of the genitourinary system.

Levomycetin

Metronidazole

One of the few remedies that helps men and women to completely recover from Trichomonas urethritis. This antibacterial medication sinks into the cellular fluid of the epithelial structure and destroys the pathogen of Trichomonas. One course of treatment is 10-15 days. The drug is taken 1-2 tablets 3 times a day. During the period of therapy, it is strictly forbidden to drink alcohol, since there will be no positive result. A pack of Metronidazole costs 55 rubles.

Monural

Nitroxoline

One of the oldest antibiotics, since it has been invented and produced since the late 60s. It is not addictive and can be taken by patients over a long period of time. Relieves inflammation of the mucous membrane of the urethra and kidney tissue, facilitates the outflow of urine and reduces pain. Patients are taken 2-3 tablets 4 times a day. The cost of the drug is 45 rubles per pack.

Nolitsin

It is intended for the treatment of urethritis caused by streptococcal infection. It is considered a potent antibiotic, so the dosage is selected individually by the attending physician. The approximate duration of therapy is 10-12 days. One pack of Nolitsin, consisting of 10 tablets, will cost the buyer 211 rubles.

Ofloxacin

These are tablets, produced in the form of yellow capsules, which are prescribed to patients suffering from urethritis, in the tests of which aerobic bacteria are found developing inside the cells of the epithelial tissues of the urethra. They relieve the patient of Trichomonas and chlamydia, which allows you to quickly relieve inflammation and alleviate the suffering of the infected. It is effective both in the treatment of women and is indicated for use in relation to men. The cost of packaging the drug will cost a person 150 rubles.

Palin

It is indicated for the systemic treatment of chronic and acute urethritis. It is prescribed to patients 1 tablet 3 times a day for 12 days. This is one course of therapy. If the disease is not completely eliminated, then after a 5-day break, it is shown to undergo a repeated treatment regimen of the same duration. In retail pharmacy chains, Palin costs from 160 to 170 rubles per pack.

Solutab

Semi-synthetic antibiotic of the tetracycline series. Used to treat bacterial urethritis and inflammation of the urinary tract caused by fungal infections. The medication is considered to be quite potent, so it is enough to take it for 10 days so that the symptoms of the disease systematically disappear, and then completely disappear. The cost of the drug is 450 rubles per pack.

Sumamed

This antibacterial agent contains an active substance - azithromycin. The medicine is intended in order to successfully fight against streptococci and all types of staphylococci, which in one way or another have penetrated the urethral canal, provoking its inflammation. The approximate duration of therapy is from 10 to 15 days. The drug is taken 1 tablet 3 times a day. The pharmacy is sold at a price of 180 rubles for a cassette of 10 tablets.

Furagin

Yellow tablets, coated with a protective coating. The drug is indicated for use in the treatment of patients with urethritis who have infected their genitourinary system with staphylococcal infection, as well as a microorganism called Clibsella. 1-2 tablets are prescribed 3 times a day. The duration of therapy is determined individually by the attending physician, since the medication is not addictive and can be used longer than most drugs. The price of the medicine is within 180 rubles.

Furadonin

It is considered one of the oldest and most time-tested drugs invented to fight infections of the genitourinary system. It is recommended to use in the early stages of the development of the disease, when urethritis is only showing its clinical symptoms. The patient should drink 1 tablet daily 3 times a day 10 minutes before meals.

The course of treatment is 12 days, but it can be extended at the insistence of the doctor. The cost of the product is 90 rubles per package.

Furamag

These are capsules, inside of which there is a free-flowing powder that has a complex antibacterial effect. Furamag tablets allow you to eliminate a bacterial infection located in the urethra in a short period of time, and the active components of the drug practically do not cause concomitant side effects. Contraindicated in people suffering from chronic liver disease. The price of the drug is within 190 rubles per pack.

Ceftriaxone

Third generation antibiotic. It is intended for the treatment of patients who suffer from an acute form of bacterial urethritis, but at the same time are prone to negative allergic reactions to most antibacterial drugs. It is prescribed to take 1-2 tablets 3 times a day for 7-10 days. In case of signs of a disorder of the digestive system, it is recommended to stop treatment. The cost of this medication is 350 rubles.

Tsiprolet

Antimicrobial agent from the category of fluoroquinolones. It is prescribed in case of detection of such pathogenic microorganisms in a patient as Staphylococcus aureus, Pseudomonas aeruginosa, staphylococcal infection. It is not used for systemic, breastfeeding, and is also contraindicated in children under 12 years of age. The approximate duration of one therapeutic course is 14 days. During this period of time, the patient takes 1 tablet of the medication 2-3 times a day. The price of the drug is 220 rubles.

Erythromycin

A broad-spectrum antibacterial agent that looks like small white round tablets. Effective against almost all types of bacteria. Not used for and fungal urethritis. It is prescribed 1-2 tablets 3-4 times a day 1 hour before or after meals. You cannot combine the intake of Erythromycin and the use of alcoholic beverages, otherwise the effect of the drug will be exactly the opposite. Using this antibiotic, you can completely get rid of urethritis in 10-15 days.

All the described types of tableted antibiotics are actively used in practical medicine by urologists, gynecologists, dermatologists and venereologists to relieve the patient of signs of bacterial inflammation of the walls of the urinary canal mucosa.

Candles

This type of medication is intended for the treatment of urethritis in the female half of the population, since the physiology of the structure of the male genitourinary system does not allow to fully realize the pharmacological properties of suppositories. This is due to the fact that it is longer and is divided into 4 sections, of which only one, located in the area of ​​the prostate gland and anus, can be treated with antiseptic suppositories. If the inflammation is localized in the anterior part of the urinary canal, then suppositories will not be effective. For men, suppositories are inserted into the rectum, and for women into the vaginal cavity. To achieve the maximum therapeutic effect in a short period of time, the following types of suppositories are used.

Hexicon

These candles contain Horhexidine, which is considered a universal antiseptic. There are no contraindications, so the drug is used to treat patients with various complications and regardless of the form of urethritis. The best therapeutic effect of the drug is observed in the early stages of the development of the disease. Works against microorganisms of fungal origin. Approved for use in the treatment of pregnant women who have been found to have signs of inflammation of the urinary tract. Suppositories are injected 1-2 times a day for 5 days.

McMiror

This drug contains the active substance Niforatel and Nystatin. It does not have a toxic effect on the body of a patient with urethritis, which is very important in inflammatory processes in the organs of the genitourinary system, since the kidneys with such pathologies become greatly weakened. The principle of using drugs is such that the patient is administered 1 suppository per day for 10 days. If the therapeutic effect came earlier, then the course of treatment is still brought to the end in order to avoid a possible relapse of the disease.

Polygynax

Used to treat urethritis in both men and women. Helps to get rid of inflammation of the urinary tract caused by the penetration of candidal microorganisms into its walls. It is forbidden to use women in the first trimester of pregnancy, as well as breastfeeding.

Diclofenac

Potent suppositories that are inserted exclusively into the rectal opening regardless of the patient's gender. They destroy most of the bacteria known to science, the presence of which can cause the development of urethritis. Against the background of high efficiency, it has a large list of side properties, therefore, these suppositories cannot be introduced into the body for people suffering from renal and heart failure, stomach ulcers, and allergic intolerance to aspirin.

Vaginal and rectal suppositories are quite specific types of medications, therefore, independent use of this medication is not recommended. Before starting treatment, it is imperative to consult a doctor.

Ointments

Ointment-based antibacterial drugs are also included in the course of therapy, but much less often from tablets and anti-inflammatory suppositories. Nevertheless, for the fastest possible cure for urethritis, it is recommended to use the following ointments.

Cycloferon

The drug is applied to the surface of the epithelium of the head in men and the labia minora in women. The tissue located in the circumference of the entrance to the urethra is also treated with ointment. The drug itself has antibacterial and antiviral properties, stimulates the cells of the local immune system to increase resistance to inflammatory disease. Approved for use for the treatment of women in a state of pregnancy.

Levomekol

It is applied to the surface of male and female genital organs according to the same principle as Cycloferon ointment. Nevertheless, this medication has several disadvantages. This type of ointment really successfully destroys pathogenic microflora in the urethra, but at the same time negatively affects the state of other organs of the human body. Levomekol should not be used by people suffering from chronic liver and kidney diseases. For children and pregnant women, as well as breastfeeding a newborn, Levomekol ointment is categorically contraindicated. In addition, the medication has the ability to cause allergic reactions of varying severity, but at the same time, in its effectiveness, no other antibacterial ointment can be compared with it.

Erythromycin

This type of ointment-based antibiotic is analogous to a tablet product. The only difference is that in this case, Erythromycin plays the role of a local drug in order to affect the focus of infectious inflammation directly at the site of its manifestation. The medication is effective only if the disease develops in the anterior urethra. The ointment will not penetrate into more distant parts of the urinary canal and it is impossible to deliver the medicine there from a physiological point of view. In general, the drug is in demand in those clinical situations when the infection goes beyond the urinary canal and begins to spread on the surface of the genitals, expressed in a characteristic red rash, itching and the appearance of ulcers.

In general, ointment antibacterial drugs in the treatment of urethritis are used very rarely and in fact only in extreme cases with severe forms of the disease, in order to use all possible means in the fight against the disease.